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Tonsillitis is an inflammation of the tonsils caused by an infection. Years ago, many young children had their tonsils removed. In fact, surgery was once the standard treatment for tonsillitis, an inflammation of the tonsils caused by a viral or bacterial infection.

Doctors today are much less likely to recommend removal of the tonsils. In part, that's because tonsillitis often can be treated effectively with home care or antibiotics. It's also now known that tonsils — specialized lymph nodes on either side of your throat — are a normal part of your body's immune system.

If treated with appropriate antibiotics, the symptoms of bacterial tonsillitis should disappear in just a few days. Surgery is generally considered only if tonsillitis affects your child's breathing or swallowing, or if the condition reoccurs often.

Signs and symptoms

Tonsillitis typically causes your child's tonsils to become visibly red and swollen. You may also notice patches of white discharge on infected tonsils. Other signs and symptoms of tonsillitis include:

  • Severe sore throat

  • Difficult or painful swallowing

  • Headache

  • Fever and chills

  • Enlarged, sore glands in the jaw and neck

  • Changes in or loss of one's voice


Your tonsils are a pair of specialized lymph nodes located on either side of your throat, just behind and above your tongue. They're part of your body's immune system that helps protect you from microorganisms that can cause infection. Tonsils store white blood cells to engulf bacteria and viruses as they enter through your nose and mouth.

When bacteria and viruses are engulfed by white blood cells, a low-grade infection in your tonsils may result. This minor infection then stimulates your body's immune system to form antibodies against future infections. But sometimes your tonsils may be overwhelmed by a bacterial or viral infection, and they swell and become inflamed. The result is tonsillitis.

A number of respiratory viruses can cause tonsillitis, including the Epstein-Barr virus (EBV). This is the same virus that can cause mononucleosis. Some strains of bacteria also can cause tonsillitis. The most common culprit is the same bacterium that causes an infection of the throat commonly known as strep throat. The bacterium is Streptococcus pyogenes, or group A beta-hemolytic streptococcus.

Risk factors

Tonsillitis is a common condition, especially in children. Viruses and bacteria tend to flourish where people — especially children — are in close contact for several hours each day, such as at school or at a child-care facility.

When to seek medical advice

Although tonsillitis itself usually isn't serious, it can lead to complications if left untreated. Call your doctor if your child meets one or more of the following criteria:

  • Has symptoms of tonsillitis that last longer than 48 hours, especially if accompanied by a high fever (a high fever in a child is 103 F or higher)

  • Has a sore throat that worsens

  • Has been exposed to strep throat

Get medical care right away if your child has trouble breathing or has a lot of trouble swallowing. Also seek immediate medical attention if he or she develops new signs or symptoms, such as a severe headache, chest pain, joint pain, a rash or vomiting.


Left untreated, tonsillitis can lead to a collection of pus (an abscess) between a tonsil and the soft tissues around it (peritonsillar abscess). The abscess may cover a large part of the soft area at the back of the roof of your child's mouth (soft palate). Sometimes the swelling can be so severe that the roof of the mouth and tongue meet, blocking air flow and making swallowing extremely difficult. In rare cases the abscess could even spread into the bloodstream or into the neck or chest.

Some strains of streptococcal bacteria that cause tonsillitis can also cause kidney inflammation (nephritis) or rheumatic fever, an inflammation that may affect the heart, joints, nervous system and skin. This is one reason it's vital that your child complete the entire course of medication your doctor prescribes for a bacterial infection.

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