Kids and Health Care: Tonsillitis
The tonsils are fleshy clusters of tissue that lie in bands on both sides of the back of the throat. Tonsillitis is an inflammation of the tonsils caused by an infection. In tonsillitis, the tonsils are enlarged, red and often coated (either partly or entirely) by a substance that is yellow, gray or white. Tonsillitis usually occurs as part of a pharyngitis (throat infection). In older children, the illness usually begins with sudden sore throat and painful swallowing. A child may also experience loss of appetite, chills and high fever. Glands in the neck and at the angle of the jaw may be swollen and tender.
In infants, tonsillitis may include symptoms that appear to be less focused on the throat, such as poor feeding, runny nose and a slight fever.
As with many children's health issues, pediatricians used to use surgery a lot more quickly...and frequently...than they do today. As recently as the 1980s, doctors would remove infected tonsils more than two-thirds of the time. More current statistics suggest they cut on fewer than half of the cases.
Tonsillitis is caused by viruses or bacteria; the symptoms are often the same no matter what sort of germ is causing the infection. Bacterial tonsillitis can be treated with antibiotics, but viral tonsillitis cannot. Doctors differentiate between the two by taking a throat culture (a painless swab of the back of the throat) or a quick strep test. In about 15 percent of throat cultures, streptococci are found, and the infection is presumed to be a strep infection; in the other 85 percent of throat cultures that are negative for strep, the cause of the throat infection is usually a virus.
To prevent tonsillitis, avoid exposure to anyone who already has tonsillitis or a sore throat. At home, when someone is infected with tonsillitis, be sure to keep drinking glasses and eating utensils separate, and wash dishes in hot, soapy water. All family members should wash their hands frequently.
All forms of tonsillitis, whether caused by bacteria or viruses, are contagious illnesses. Tonsillitis usually spreads from person to person by contact with the throat or nasal fluids of someone who is already infected. This is why parents who care for a child with tonsillitis should keep the child's drinking glass and eating utensils separate from those of other family members. They should also wash their hands frequently as they care for a child who is sick with tonsillitis, especially if they are also caring for younger children who are not ill.
Infections caused by streptococci cause special problems. Estimates are that in a home where someone already has strep, about one out of every four family members will get it, too. Some children can be carriers of strep bacteria without having any symptoms. Among school-age children, one in five may be asymptomatic carriers of strep bacteria.
Call the doctor if your child has symptoms of tonsillitis, including sore throat, painful swallowing, headache, fever, chills or swollen neck glands.
If your child is already being treated for tonsillitis, call your child's doctor immediately for any of the following symptoms: fever that returns after several days of normal temperature; skin rash; earache; nasal discharge that's discolored or bloody; cough, especially if it produces mucus; chest pain, shortness of breath or extreme tiredness; convulsions; painful, red or swollen joints; nausea or vomiting.
