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Tonsillitis; tonsils; ;

Tonsils are glands at the side and the back of the throat that help the body fight infections. Tonsillitis is when there is an infection of the tonsils, usually caused by a virus. Only about 15% are caused by bacteria.

The tonsils can become very large and sore during tonsillitis. They can remain large if they are infected often.



Any child who is very unwell, with a fever and sore throat should be seen by a doctor.

What are the signs of tonsillitis?

  • The signs of tonsillitis are sore throat, fever, and difficulty swallowing.
  • The signs are very similar for tonsillitis that is caused by a virus and tonsillitis that is caused by bacteria.
  • It is more likely to be a virus if there are other signs of a 'cold' such as runny nose, sore eyes and a cough.
  • The tonsils can be very large with tonsillitis, but they are also fairly large in young children even when they are well. Sometimes they can make it hard for the child to breathe or swallow, but this is very unusual.
  • The tonsils look large, red and often have white patches on them.

 tonsil2.gif (4852 bytes)
Normal tonsils              Tonsillitis

  • Glandular fever can cause severe tonsillitis. If people have glandular fever they do not respond to antibiotics containing amoxicillin and may get a rash.

What to do

  • Children may need paracetamol for pain relief (see 'Using paracetamol or ibuprofen').
  • The topic 'Feeling sick' has suggestions for caring for a sick child.
  • Give cool soft food such as custards and jelly and extra drinks.
  • Don't worry if your child does not want to eat much when her throat is sore. Cool or slightly warm drinks are often easier to swallow than icy cold drinks.
  • If the tonsillitis is caused by a viral infection, antibiotics do not help. However if the tonsillitis is caused by bacteria and the doctor decides that antibiotics are needed, the fever usually drops within 24 hours, and the child will recover on average about 36 hours faster than if she does not have antibiotics. A child with bacterial tonsillitis will recover if she does not have antibiotics - it just takes a little longer.
  • To decide whether antibiotics are needed, a throat swab might be taken ('cotton wool' on a stick is wiped over the tonsils and then tested at the doctor's clinic or sent to a laboratory).

Your doctor will take lots of things into account before suggesting that your child have her tonsils out. These will include the number of times she has had tonsillitis (these usually get less as a child grows older) and the difficulty the child has sleeping (they can contribute to sleep apnoea).

  • There are risks when surgery is done to remove tonsils, including problems with anaesthetics during the operation and bleeding after the operation. However, almost always there are no problems.
  • Tonsils may be taken out if the child has a lot of attacks of tonsillitis each year for a couple of years. The child usually needs to be at least 3 years old. 

Preventing others from catching tonsillitis

  • Tonsillitis often develops when a child has a cold so it is nearly impossible to prevent it from happening.
  • Usually people can pass on the virus from when they first get signs of being unwell to about five days after the illness starts - so the virus can be spread to other people even before the tonsillitis develops.
  • If the tonsillitis is caused by bacteria and the child has antibiotics he or she will not be infectious about 24 hours after starting the antibiotics.
  • There is no immunisation against tonsillitis.

Health problems from tonsillitis

  • Rheumatic fever used to be a risk following untreated streptococcal tonsillitis (a type of tonsillitis caused by bacteria), but this is rare now in Australia, probably largely due to a change in the nature of the bacterium.
  • Rarely disease of the kidney (acute glomerulonephrosis) can occur after a streptococcal throat infection.
  • Ear infections and chest infections usually do not happen at the same time as tonsillitis. 
  • Quinsy, which is an abscess next to the tonsils, is another rare complication which can be a medical emergency. Signs are becoming increasingly unwell, a high fever, localised swelling around the angle of the jaw, difficulty swallowing. If a person has quinsy, an emergency operation to drain the abscess is often needed.

More information

Raising Children Network 

Better Health Channel (Victoria) 

Department of Health, South Australia

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The information on this site should not be used as an alternative to professional care. If you have a particular problem, see a doctor, or ring the Parent Helpline on 1300 364 100 (local call cost from anywhere in South Australia).

This topic may use 'he' and 'she' in turn - please change to suit your child's sex.

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