Tonsillitis in kids & teens: essential parent information

What is tonsillitis?

Tonsillitis is when the tonsils get inflamed. If you look into your child’s mouth, you might see that the tonsils look red and swollen. They might also have white spots on the surface.

The tonsils are 2 pieces of tissue at the back of the mouth on the sides of the throat. You can often see them if your child ‘opens wide’ and you look into their mouth. The tonsils work as part of the immune system.

What causes tonsillitis?

Tonsillitis is usually caused by viruses like the common cold, flu or glandular fever.

Sometimes a bacterial infection can cause tonsillitis. Bacterial causes include streptococcal infection (Streptococcus A), also called strep throat.

Children under 3 years don’t often get bacterial tonsillitis.

What are symptoms of tonsillitis in kids?

If your child has tonsillitis, they’ll have a sore throat.

Your child might also have:

Depending on the cause of the infection, your child could also have a rash.

Tonsillitis symptoms usually improve after a few days and go away within a week, especially if your child is older and their symptoms are mild. This can happen even with mild tonsillitis that keeps coming back. If your child’s symptoms are more severe, the tonsillitis might need medical treatment.

Should your child see a doctor about tonsillitis symptoms?

You should take your child to see the GP if your child:

refuses to drink fluids
vomits frequently.

If you’re worried about your child’s symptoms, you should also see the GP.

Your GP might order a throat swab to check whether a virus or bacteria is causing the infection. The GP might also suggest a blood test, which can look for glandular fever.

When is tonsillitis an emergency?

You should take your child to a hospital emergency department straight away if they:

seem dehydrated – they’re doing fewer wees than usual or no wees at all, look pale and thin, have sunken eyes, cold hands and cold feet, or are drowsy or cranky
complain of an intense headache
are pale and sleepy
have trouble breathing or swallowing their saliva
have a stiff neck
feel tightness in their jaw.

How to treat tonsillitis symptoms

When your child has tonsillitis, you can treat the symptoms by giving your child:

small, frequent sips of water or an oral rehydration fluid like Gastrolyte or Hydralyte, which you can get at pharmacies and supermarkets
fluids via a syringe or spoon
icy poles
paracetamol or ibuprofen in recommended doses to help with the pain.

Your GP might prescribe antibiotics if they think the infection is severe and there might be complications. But most children don’t need antibiotics.

Sometimes your GP might suggest a short course of corticosteroids if your child has a lot of pain.

Will your child need a tonsillectomy?

A tonsillectomy is surgery to remove the tonsils.

Tonsillectomy is not a routine operation, unless your child has severe tonsillitis that keeps coming back over an extended period – for example, a year or so. If your GP feels your child might benefit from tonsillectomy, the GP will send you and your child to an ear, nose and throat specialist.

The tonsils are only a small part of your child’s immune system, so tonsillectomy does not lead to more infections.

Is tonsillitis contagious?

Tonsillitis is contagious.

If your child has tonsillitis, it’s best for them to avoid sharing cups and cutlery.

It’s also a good idea to replace your child’s toothbrush after their sore throat or fever has gone. This will help to prevent the germs reinfecting their throat.

Can tonsillitis cause complications?

Bacterial tonsillitis can cause complications like:

middle ear infection
an abscess around the tonsil or one in the neck
scarlet fever, which is a severe form of tonsillitis with a rash.

Rarely, streptococcus infections can cause complications like:

rheumatic fever, which can damage the heart valves
acute glomerulonephritis, which affects kidney function.