Pediatric Tonsillitis

What are the tonsils?

The tonsils are located in the back of the throat. They are part of a group of lymphoid tissue that collects bacteria and viruses that cause upper respiratory tract (nose and throat) infections. They also help to produce proteins (immunoglobulins) that help the body fight infections. Although the tonsils have a role in helping treat infection, the tonsils can become part of the infection as well. When this happens, the removal of the tonsils will improve your child’s health. Removal of the tonsils has not led to an increase in infections or a loss of immune (disease-fighting) function. This is because there are hundreds of other lymph nodes in the head and neck that perform the same function.

Where are the tonsils?

There are four areas of tonsil tissue located in the back of the throat The tissue referred to as the “tonsils” is located on either side of the back of the mouth. The second area of tonsil tissue is located behind the nose and is called the ADENOID. The fourth area of tonsil tissue is located behind the tongue; it does not usually cause any difficulties and is rarely ever removed.

What is tonsillitis?

Tonsillitis is an infection of the tonsils. This infection usually involves the back of the throat as well (pharyngitis). This infection is uncommon in children less than one-year-old. It is seen most frequently in children four to seven years of age and continues less frequently throughout late childhood and adult life.

What are some of the causes of tonsillitis?

In about 85% of cases, viruses are the most common cause of tonsillitis. The second most common cause is a bacteria known as Streptococcus (Group A Beta hemolytic Streptococcus), otherwise known as “strep throat”. Other bacteria can cause tonsillitis, but much less frequently.

What are the symptoms of tonsillitis?

Tonsillitis usually results in a sore throat and difficulty swallowing. The throat visibly looks inflamed (red). In younger children, refusal to eat may be noted. Fever, headache, earache, and enlarged and tender glands in the neck may also be experienced.

How is tonsillitis treated?

It is important to have your primary care doctor determine if the cause of the infection is viral or bacterial.

Viral tonsillitis is primarily treated with bed rest, Tylenol (acetaminophen) for fever and pain relief, and lots of fluids. Antibiotics do not help treat this type of infection.

Streptococcal tonsillitis does require the use of antibiotics, primarily to help get rid of the infection quickly and prevent complications. Complications can include an infection in the bloodstream, heart problems, rash, and others.

What are some reasons that you may be referred to an ear, nose, and throat specialist for evaluation of tonsil removal (TONSILLECTOMY)?

Tonsillitis can become difficult to treat (chronic tonsillitis) or infections may recur frequently. This can result in fatigue, poor weight gain, and poor school attendance among other things.

Occasionally an abscess or collection of pus may develop around the tonsils and needs to be drained.

The tonsils can become so enlarged (tonsillar hypertrophy) that your child may have difficulty breathing (especially at night) or difficulty swallowing.

If enlargement of only one tonsil occurs, this may be suggestive of a malignancy (cancer) and needs to be removed for biopsy.

These are the most common indications for removing the tonsils. However, each child is evaluated based on their unique history.