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How Do I Know If My Child Has It?

To check your child's tonsils, place the handle of a spoon on her tongue and ask the child to say "aaahhh" while you direct a light on the back of her throat. If the tonsils look bright red and swollen, call your pediatrician or family doctor for examination.

Often tonsillitis due to a virus looks no different than one caused by bacteria. Your pediatrician will examine your child's tonsils and take a throat swab to check for strep throat. The test can be done with results available during the office visit. This is the rapid strep test. If this is negative a culture is done for confirmation which takes 24-48 hours. To check for a tonsillar abscess, the doctor will examine the tonsils and soft palate.

What Are the Treatments?

Since most of the time the infection is due to a virus, antibiotics are not routinely needed. For either a bacterial infection or an abscess, the doctor will prescribe an antibiotic such as penicillin or erythromycin for 10 days. Be sure to give your child the full course; if unchecked, strep bacteria can cause serious conditions such as rheumatic fever or kidney disease. If the infection is due to strep, the contagious period is within 24 hours after starting antibiotics.

If the throat culture is negative for bacteria, the infection is probably caused by a virus and requires only treatment for relief of symptoms. To ease pain, the doctor may also recommend acetaminophen (Tylenol) or ibuprofen (Advil). (CAUTION: Do not give your child aspirin, which has been linked to Reye's syndrome, a life-threatening condition.) Gargling three times a day with warm salt water (1 teaspoon of salt in 8 ounces of warm water) may relieve some of the pain.

If your doctor discovers an abscess, he may drain it before administering antibiotics.

Severe cases of tonsillitis that are frequent and affect your child's general health, breathing, or hearing, or episodes that interfere with school attendance may warrant surgical removal of the tonsils (tonsillectomy). This procedure is performed as outpatient surgery. The child stays in the hospital for just a few hours.

While your child is recovering, keep him or her indoors but not necessarily in bed in a warm, but not hot room. Try to get your child to take plenty of fluids, but don't force them to eat or drink. Older children should be given at least a pint of extra liquids per day. Offer ice cream or other cool desserts to cool the throat. Never administer cold water enemas to relieve fever.

How Can I Prevent Tonsillitis?

Hand washing remains crucial in preventing the spread of viruses and bacteria that cause tonsillitis. Avoid prolonged contact with anyone who has strep throat and has not been taking antibiotics for at least 24 hours.

Tonsillectomy, the surgical removal of the tonsils, is performed much less frequently today than in years past. Doctors now generally recommend the operation only in serious cases, such as when tonsillar abscess is a recurring problem.