By Raising Children Network
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The tonsils are two pieces of tissue at the back of the mouth, which work as part of the immune system. Tonsillitis is when the tonsils get inflamed. It’s a fairly common upper respiratory tract infection in children.


Tonsillitis (inflammation of the tonsils) is most often caused by one of the common viruses.

Sometimes it can be caused by bacteria. It’s often difficult to tell the difference between viral and bacterial tonsillitis.

Bacterial causes include streptococcal infection (caused by Streptococcus Group A). Left untreated, this kind of infection can cause complications such as scarlet fever, middle ear infections and, rarely, rheumatic fever (which affects the heart) or glomerulonephritis (which affects the kidneys).

Bacterial tonsillitis is uncommon in children under five.


Your child will complain of a sore throat and sometimes of difficulty in swallowing. Your child might have a fever or swollen, tender glands in her neck. Your child will also often complain of a headache, a runny nose and many of the symptoms of a cold.

Tonsillitis symptoms usually improve after a few days and disappear within a week.

When to see your doctor

You should see a doctor if your child:

  • refuses to drink fluids
  • vomits frequently
  • complains of an intense headache
  • is pale and sleepy
  • has trouble breathing
  • has a high fever that doesn’t respond to paracetamol
  • doesn’t show some improvement in 48 hours, or if you’re worried.


Your doctor might order a throat swab to check whether a virus or bacteria is causing the infection. Occasionally a blood test might be helpful.


It’s often difficult to tell the difference between an infection caused by a virus and one caused by bacteria.

If the infection is caused by a virus, your child won’t need any specific treatment.

If there’s pus on the tonsils, it’s probably a bacterial infection. In this case, your doctor will often prescribe a course of antibiotics. This will probably be in a mixture, tablets or capsules for your child to take by mouth.

Generally, treatment for tonsillitis is similar to that suggested for a cold. Frequent warm drinks might ease a sore throat, and paracetamol might relieve pain and fever. It’s important to keep your child well hydrated.


There’s no effective way to prevent tonsillitis.

  • Last updated or reviewed 16-05-2011