Tonsillitis in children

Overview

Tonsillitis is an infection that makes the tonsils (the two small lumps at the back of your throat) swollen and sore. It is a common illness in children and usually gets better on its own.

Yes, tonsillitis is extremely common in children, especially between the ages of 5 and 15.

It mostly affects children and teenagers, but adults can also get it.

Symptoms

Common symptoms

• Sore throat
• Swollen red tonsils
• Pain when swallowing
• Fever (high temperature)
• Headache
• Feeling tired

Symptoms in children

• Stomach ache
• Nausea or vomiting
• Refusing to eat or drink
• Drooling more than usual
• Irritability

Symptoms in older adults

• Tonsillitis is less common in older adults, but symptoms can include severe sore throat, difficulty swallowing, and swollen neck glands.

Causes

Main causes

• Viral infections (most common) – like cold viruses, flu, or glandular fever.
• Bacterial infections – usually group A streptococcus (strep throat).

Risk factors

• Close contact with someone who has tonsillitis or a sore throat.
• Being a child or teenager (tonsils are more active at this age).
• Weakened immune system from another illness.

When to see a doctor

See a doctor urgently if:

• Your child has trouble breathing or is drooling more than usual.
• Your child is very dehydrated (not weeing for 8–12 hours, dry mouth).
• High fever does not come down with medicine or lasts more than 3 days.

Book a routine appointment if:

• The sore throat lasts longer than 2–3 days.
• You are worried about your child’s symptoms.
• Your child has tonsillitis very often (many times in a year).

Diagnosis

A doctor will ask about your child’s symptoms and look inside their throat, ears, and nose. They may feel the neck for swollen glands.

Tests that may be done

• Throat swab – a soft cotton bud is wiped over the back of the throat to test for bacteria (strep).
• Rapid strep test – results in a few minutes.
• Sometimes a blood test if the cause is unclear.

What to expect at your appointment

The doctor will explain what they find and recommend the best care. Diagnosis is usually quick and painless (the throat swab may be a little uncomfortable but only lasts a second).

Treatment

Treatment depends on whether the infection is viral or bacterial. Viral tonsillitis needs only rest and home care. Bacterial tonsillitis may need medicine (antibiotics) from a doctor.

Self-care at home

• Give your child plenty of fluids – water, milk, or warm (not hot) drinks.
• Offer soft, cool foods like yogurt, ice cream, or soup – avoid spicy or crunchy foods.
• Use age‑appropriate pain relief such as paracetamol or ibuprofen (follow the instructions on the bottle or packet).
• Encourage rest and quiet play.
• Keep the air moist with a cool‑mist humidifier or a bowl of water in the room.

Medical treatments

If tests show a bacterial infection (strep throat), a doctor may prescribe antibiotics. It’s important to take the full course exactly as directed. Never share antibiotics or stop early. Pain relief and fever reducers may also be advised.

When is surgery considered?

Surgery to remove the tonsils (tonsillectomy) is rarely needed. It may be considered if tonsillitis comes back very often (7 or more episodes in a year, or 5 each year for 2 years) or if it causes serious problems like breathing trouble or an abscess.

Living with this condition

Keep your child comfortable at home. Let them rest, offer lots of love and reassurance, and watch for signs of dehydration or worsening symptoms.

Lifestyle tips

• Wash hands often to stop the infection spreading to others.
• Keep your child away from school or nursery until they no longer have a fever and feel well enough to eat and drink normally.
• Avoid sharing cups, utensils, or toothbrushes.

Diet and exercise

Stick to soft, cool foods and plenty of fluids. Avoid acidic drinks like orange juice. Once your child feels better, they can return to normal activity gradually.

Mental health and emotional wellbeing

Being ill can make children feel irritable, clingy, or anxious. Extra cuddles, patience, and calm activities (like reading or puzzles) can help them feel safe.

Prevention

You cannot completely prevent tonsillitis, but good hygiene can reduce the chance of infection. Teach your child to wash their hands, cover coughs and sneezes, and avoid sharing items with someone who is sick.

Vaccines

The flu vaccine may help reduce the risk of viral tonsillitis caused by flu. There is no specific vaccine for tonsillitis itself.

Screening programmes

There is no routine screening for tonsillitis. It is diagnosed when symptoms appear.

Complications

If left untreated

• Peritonsillar abscess – a collection of pus next to the tonsil that may need draining.
• Difficulty breathing if the throat swells a lot (very rare).
• Rare spread of infection to the blood or other parts of the body.

Long-term outlook

The outlook for children with tonsillitis is excellent. Most recover fully in about a week without any lasting problems. Even if complications happen, treatment is usually effective and your child will be back to normal.

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