Few things worry parents more than a child with a high fever and a painful sore throat. One common cause of these symptoms is acute tonsillitis a sudden inflammation of the tonsils, which are two small glands located at the back of the throat. Although tonsillitis is common in children, understanding its causes, symptoms and treatment can help parents respond appropriately and avoid unnecessary panic.
Acute tonsillitis is usually caused by an infection. In many cases, the infection is viral similar to the viruses that cause the common cold or influenza. However, some cases are caused by bacteria, particularly Streptococcus bacteria, commonly referred to as “strep throat”. Children with acute tonsillitis typically present with a sudden sore throat, difficulty swallowing, fever and reduced appetite. Younger children may refuse to eat or drink because of the pain. Other symptoms can include swollen neck glands, bad breath, headache and general weakness. On examination, the tonsils may appear red, swollen and sometimes covered with white patches.
It is important for parents to know that not all cases of tonsillitis require antibiotics. Viral tonsillitis does not improve with antibiotics and usually resolves within a few days with supportive care such as adequate fluids, fever control and rest. Antibiotics are necessary only when a bacterial infection is confirmed or strongly suspected. Unnecessary antibiotic use increases the risk of antibiotic resistance and potential side effects.
Parents should also watch for warning signs that require urgent medical attention. These include difficulty breathing, drooling due to an inability to swallow, severe neck swelling, a persistent high fever, or signs of dehydration such as passing very little urine or extreme weakness. One common question parents ask is whether the tonsils should be removed. Surgery (tonsillectomy) is not the first-line treatment for acute tonsillitis. It is usually considered only if a child experiences very frequent, severe or complicated episodes that interfere with daily life or lead to serious complications. Acute tonsillitis in children is common and often mild, but it should be properly assessed by a healthcare professional. With correct diagnosis and appropriate treatment, most children recover fully within a short period.
