Tonsillitis (Child)

Front view of face with open mouth comparing oral cavity and tonsils with inflamed throat and enlarged tonsils.

Tonsillitis is an inflammation or infection of your child's tonsils. Your child has two tonsils, one on either side of their throat. The tonsils are pink, oval-shaped glands. They help prevent infections. But tonsils can become infected themselves. Tonsillitis is a common childhood condition.

Tonsillitis can be caused by bacteria or a virus. The main symptom is a sore throat. Your child may also have a fever and red and swollen tonsils. Swallowing can be painful or uncomfortable. The tonsils may also look white, gray, or yellow because of a coating on them. Your child may have swollen lymph nodes or glands in their neck.

Your child may have a rapid strep test or a throat culture. The rapid strep test gives results right away. Sometimes both tests are done. These tests will find out if your child has a bacterial or a viral infection. If your child has a bacterial infection, they may need to take antibiotics. An antibiotic is used to treat a bacterial infection. Antibiotics don’t work against viral infections. In some cases of a viral infection, your child may take an antiviral medicine. Your child may need surgery to remove the tonsils if they cause breathing problems. Or they may need surgery if they have several infections in one year.

Home care

If your child’s healthcare provider has prescribed antibiotics or another medicine, give it to your child as directed. Be sure your child finishes all of the medicine, even if he or she feels better.

To help ease your child’s sore throat:

  • Give acetaminophen or ibuprofen. Follow the package instructions for giving these to a child. Don't give aspirin to anyone younger than 18 years old who is ill with a fever. It may cause severe liver damage.

  • Offer cool liquids to drink.

  • Have your child gargle with warm salt water. Use 1 teaspoon of salt to 8 ounces of warm water.

  • An over-the-counter throat-numbing spray may also help. Talk to your child's healthcare provider before giving them any over-the-counter medicine, especially for the first time.

The germs that cause tonsillitis are very contagious. To help prevent their spread, follow these tips:

  • Teach your child to wash their hands often.

  • Don’t let your child share cups or utensils with other people.

  • Keep your child away from other children until he or she is better. Talk with your child's healthcare provider about when your child can return to school or daycare.

Follow-up care

Follow up with your child's healthcare provider, or as advised.

When to seek medical advice

Unless advised otherwise, call your child's healthcare provider if your child has any of the following:

  • Fever (see Fever and children, below)

  • A sore throat for more than 2 days

  • A sore throat with fever, headache, stomachache, or rash

  • Neck pain or stiff neck

  • Refusal to eat or has problems eating

  • Large or swollen neck

  • Acts strange or different

  • New or worsening symptoms

  • Trouble opening his or her mouth

  • A muffled voice

Call 911

Call 911 if your child:

  • Can't swallow or talk

  • Has trouble breathing or is wheezing

  • Can't open his or her mouth

Fever and children

Use a digital thermometer to check your child’s temperature. Don’t use a mercury thermometer. There are different kinds and uses of digital thermometers. They include:

  • Rectal. For children younger than 3 years, a rectal temperature is the most accurate.

  • Forehead (temporal). This works for children age 3 months and older. If a child under 3 months old has signs of illness, this can be used for a first pass. The provider may want to confirm with a rectal temperature.

  • Ear (tympanic). Ear temperatures are accurate after 6 months of age, but not before.

  • Armpit (axillary). This is the least reliable but may be used for a first pass to check a child of any age with signs of illness. The provider may want to confirm with a rectal temperature.

  • Mouth (oral). Don’t use a thermometer in your child’s mouth until he or she is at least 4 years old.

Use the rectal thermometer with care. Follow the product maker’s directions for correct use. Insert it gently. Label it and make sure it’s not used in the mouth. It may pass on germs from the stool. If you don’t feel OK using a rectal thermometer, ask the healthcare provider what type to use instead. When you talk with any healthcare provider about your child’s fever, tell him or her which type you used.

Below are guidelines to know if your young child has a fever. Your child’s healthcare provider may give you different numbers for your child. Follow your provider’s specific instructions.

Fever readings for a baby under 3 months old:

  • First, ask your child’s healthcare provider how you should take the temperature.

  • Rectal or forehead: 100.4°F (38°C) or higher

  • Armpit: 99°F (37.2°C) or higher

Fever readings for a child age 3 months to 36 months (3 years):

  • Rectal, forehead, or ear: 102°F (38.9°C) or higher

  • Armpit: 101°F (38.3°C) or higher

Call the healthcare provider in these cases:

  • Repeated temperature of 104°F (40°C) or higher in a child of any age

  • Fever of 100.4° (38°C) or higher in baby younger than 3 months

  • Fever that lasts more than 24 hours in a child under age 2

  • Fever that lasts for 3 days in a child age 2 or older

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