Angina living in infants

Overview

Angina in infants refers to inflammation of the tonsils, which are two small glands at the back of the throat. This causes a sore throat, pain, and difficulty swallowing. It is usually caused by a viral or bacterial infection.

Yes, angina is very common in infants and young children. Most children will have at least one episode before they start school.

It mostly affects children between 1 and 6 years old, but infants (up to 12 months) can also get it. Babies who are around other children are more likely to catch the infection.

Symptoms

Common symptoms

• Sore throat (baby may be fussy and refuse to feed)
• Red, swollen tonsils
• White or yellow spots on tonsils
• Fever (temperature over 38°C / 100.4°F)
• Swollen glands in the neck
• Cough or runny nose

Symptoms in children

• Same as common symptoms, plus:
• Drooling more than usual
• Difficulty swallowing – may cry when trying to eat or drink
• Irritability or crying more than normal
• Bad breath

Causes

Main causes

• Viral infections (such as cold viruses, influenza, or adenovirus) – the most common cause.
• Bacterial infections, especially group A streptococcus (strep throat) – less common but may require antibiotics.

Risk factors

• Attending daycare or preschool where infections spread easily
• Being around older siblings or other children
• Weakened immune system due to illness or medical treatment

When to see a doctor

See a doctor urgently if:

• Call emergency services if your baby has trouble breathing or severe symptoms listed above.
• See a doctor the same day if your baby has a high fever, is not drinking, or shows signs of dehydration.

Book a routine appointment if:

• Schedule a doctor’s visit if symptoms last more than a few days or if you are worried about your baby’s comfort.
• If your baby gets frequent sore throats, the doctor may want to check for other causes.

Diagnosis

The doctor will look at your baby’s throat and tonsils with a light, feel the neck for swollen glands, and take your baby’s temperature.

Tests that may be done

• A throat swab – a sterile cotton stick rubbed gently on the tonsils to test for bacteria (like strep).
• Sometimes a rapid antigen test or culture to confirm bacterial infection.

What to expect at your appointment

The diagnosis is usually straightforward. If a bacterial infection is found, the doctor may prescribe antibiotics. If it is viral, no specific medicine is needed – just supportive care.

Treatment

Treatment depends on the cause. Viral infections require only comfort care, while bacterial infections may need antibiotics. Never give aspirin to children.

Self-care at home

• Offer plenty of fluids – breast milk, formula, or water if over 6 months. Small, frequent sips help.
• Give age-appropriate pain relief (like paracetamol or ibuprofen) – always follow dosing instructions from your doctor or pharmacist.
• Use a cool-mist humidifier in the room to ease dry throat.
• Offer soft, cool foods – like yogurt or pureed fruit – if baby is old enough.

Medical treatments

Bacterial angina is usually treated with a course of antibiotics. The doctor will decide which antibiotic is best – always complete the full course even if symptoms improve. Antibiotics are not effective against viral infections.

When is surgery considered?

Surgery (tonsillectomy – removal of the tonsils) is rarely needed in infants. It may be considered if the child has very frequent, severe infections that do not respond to other treatments.

Living with this condition

During an episode, focus on keeping your baby comfortable and well-hydrated. Monitor for any worsening symptoms. Most babies recover within a week.

Lifestyle tips

• Keep your baby away from smoke and irritants.
• Wash your hands often to prevent spreading the infection.
• Keep your baby home from daycare until fever and pain improve and they are eating and drinking normally.

Diet and exercise

No special diet is needed. Offer soft, moist foods if your baby is eating solids. Do not force feeding – prioritize fluids.

Mental health and emotional wellbeing

Caring for a sick infant can be stressful for parents. It is normal to feel worried. Take breaks when you can and ask for help from family or friends.

Prevention

It is difficult to prevent all infections, but good hygiene helps. Wash your hands and your baby’s hands often, avoid sharing cups or utensils, and keep your baby away from people who are sick.

Vaccines

Vaccination against the flu and other childhood illnesses (like measles, mumps, and rubella) can reduce the risk of some viral infections that cause angina. Follow the recommended immunization schedule.

Screening programmes

There is no routine screening for angina in infants. Testing is only done if symptoms suggest a bacterial infection.

Complications

If left untreated

• If bacterial strep infection is not treated, it can lead to complications like ear infections, sinusitis, or abscesses near the tonsils (peritonsillar abscess).
• Rarely, untreated strep can cause rheumatic fever (affecting the heart) or kidney problems (post-streptococcal glomerulonephritis).

Long-term outlook

With proper care, most infants recover fully from angina without any long-term problems. Even in cases of bacterial infection, antibiotics are very effective. Serious complications are very rare when treatment is given on time.

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