Dr David Lowinger MBBS FRACS Ear Nose & Throat Specialist Surgeon
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Children

Tonsillitis

Tonsillitis is the inflammation of the tonsils caused by viral or bacterial infection. Tonsils are located at the back of the throat and their main function is to fight against bacteria, virus, or other germs that enter through mouth or nose. Tonsillitis spreads through air from infected person to healthy child.

Causes

The viral infection caused by Epstein-Barr virus and streptococcus group A bacteria are the most common causes of tonsillitis in children.

Symptoms

Most common symptoms of tonsillitis are fever, severe sore throat, and pain while swallowing. The tonsils will appear red and swollen and may have white pus spots on the surface. Child may often lose appetite and may decrease intake of fluid because of pain. Other symptoms include cough, headache, nausea and vomiting, running nose, muscle pain, bad breath, ear pain, change in voice, and chills.

Diagnosis

Your doctor will ask your child's medical history and perform physical examination of your child's mouth and throat.

Your doctor will perform other tests to confirm tonsillitis:

  • Strep test: A sterile swab of the throat secretions is collected and sent off to the laboratory to assess for streptococcal bacteria, Strep throat
  • Blood test: A complete blood count (CBC) may be requested which helps to identify the cause of infection

Treatment

  • Conservative treatment: Your doctor will treat your child for bacterial tonsillitis with antibiotics that will help to fight against the bacteria and reduce painful symptoms. Your child's condition will improve after antibiotic treatment in about 2 or 3 days. The course of antibiotics should be completed and should not be stopped in between even after the symptoms subside, or else the infection may recur. Usually the oral treatment should be continued for 10 to 14 days.

    At times, also a single-dose of antibiotic injection may be suggested in children who are allergic to pills or tablets. If your child is allergic to penicillin then erythromycin will be given. Throat pain and fever will be treated by medicines such as ibuprofen or acetaminophen. Plenty of fluids should be consumed to avoid dehydration.
    Gargling with warm salt water will help to relieve throat pain which can be followed up to 7 days.

  • Surgical treatment: If your doctor diagnoses chronic tonsillitis in your child due to frequently recurring infections, then surgical removal of tonsils will be done by a pediatric otolaryngologist, an ENT surgeon for children. The goal of surgery is to reduce the number of throat and ear infections and improve airway obstruction.

Complications of surgery

The possible complications of surgical removal of tonsils include bleeding and infection at the operated site, allergic reactions to medications, blood loss, and nerve damage. These complications are rare but it is better to be aware of the complications that may occur with this operation.

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Royal Australasian College of Surgeons The Australian Society Of Otolaryngology Head And Neck Surgery Australian New Zealand Society of Paediatric Otorhinolaryngology (ANZSPO) The University of New South Wales The University of Sydney Harvard Medical School

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