Why is it so bad?

One morning, your son wakes up and tells you that he has a sore throat and it hurts to swallow. You look in his mouth and notice that the back of his throat looks red and swollen. So, you take him to the doctor, who tells you your son has tonsillitis. What can be done to treat it? Is it going to involve surgery? Is there anything you can do to prevent it in the future?


The two oval-shaped pads of tissue (one on each side) in the back of your throat are your tonsils. When you’re a child, they play a significant role in your immune system’s ability to protect you against harmful bacteria and viruses in your mouth. When your tonsils are infected, it’s known as tonsillitis. It’s most often caused by the bacterium called Streptococcus pyogenes. Tonsillitis typically infects children between preschool and mid-teens because their role in your immune system declines after puberty.

Symptoms of tonsillitis are red/swollen tonsils, white/yellow patches on the tonsils, sore throat, difficult/painful swallowing, fever, enlarged glands in the neck, bad breath, stiff neck, headache, and stomachache. For children who are too young to verbalize how they are feeling, it’s common for them to be unusually fussy and drool/refuse to eat because their throat hurts. If not treated promptly, tonsillitis can lead to severe complications, such as difficulty breathing, tonsillar abscess, and rheumatic fever. So, if your child has a sore throat that doesn’t go away in 24 to 48 hours, it’s painful for them to swallow, and they are unusually fussy/weak, you should schedule an appointment with their doctor. If your child is having difficulty breathing, difficulty swallowing, or drooling, you need to seek immediate medical care.


To adequately treat tonsillitis, you need to know if a bacteria or virus is causing it. The best way to do this is by a throat swab, which most doctors’ offices and clinics can get a result within a few minutes. If the rapid test comes back positive, it usually means that bacteria is causing the infection. If it’s negative, it’s the result of a virus.

For viral tonsillitis, your child will get better on their own in 7 – 10 days. However, there are things that you can do at home to help ease their discomfort. It’s key to encourage them to rest as much as possible and drink plenty of water so they don’t get dehydrated. You can give them warm or cool liquids, whichever they prefer, to soothe their throat. If they are old enough to gargle, you can have them do this with salt water because it also alleviates discomfort. The same is true for lozenges. It is extremely beneficial to have them sleep in a room with a cool-air humidifier or sit with them in a steamy bathroom. Avoid anything that might irritate their throat, like cigarette smoke or cleaning products. Make sure to treat any fevers or pain they are having with ibuprofen or acetaminophen.

In addition to all of the treatments for viral tonsillitis, bacterial tonsillitis needs to be treated with antibiotics, which is penicillin unless your child has an allergy to it. It’s essential that your child finishes all of the antibiotics, even if they start feeling better. If they don’t, they’re at risk for worsening infection or it spreading elsewhere in their body.

The removal of tonsils used to be a commonplace treatment for tonsillitis. However, this is no longer the case. Instead, it’s generally reserved for those that get tonsillitis frequently, bacterial tonsillitis that isn’t responsive to treatment, or to manage complications (ex. difficulty breathing). Frequent tonsillitis is classified as having more than seven infections in a year, more than four to five infections in the previous two years, or more than three infections a year in the prior three years.

Due to the advances in medical technology, tonsillectomies are usually performed as an outpatient procedure unless your child is very young, has complex medical issues, or has complications that arise during surgery. Complete recovery from a tonsillectomy can be expected in about 7 – 14 days.


The bacteria and viruses that cause tonsillitis are highly contagious, so the best way to prevent your child from contracting it is to teach them how to wash their hands properly. They should be doing this not only thoroughly but frequently. Also, encourage them not to share food, glasses, water bottles, and utensils with others. If your child does end up with tonsillitis, there are things that you can do to prevent the spread to others. The most important is to keep your child home until their doctor tells you it’s okay for them to return to school or daycare. Also, teach your child to cough/sneeze into a tissue or elbow and to wash their hands after doing so.

Tonsillitis is not something you want your child to have, but it can be managed, and they’ll get better. If you have any questions or concerns about tonsillitis, please speak with their doctor. If you would like more information, please visit ENThealth’s tonsillitis page at https://www.enthealth.org/conditions/tonsillitis/