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Tonsillitis is an inflammation of the tonsils most common in children and adolescents. It is typically caused by a virus, although it can also be caused by a bacterial infection. Common symptoms include sore throat, difficulty swallowing and fever.

Most cases of tonsillitis resolve on their own within 4 to 10 days. Treatment depends on whether tonsillitis is caused by a virus or bacteria, so it’s important to get an accurate diagnosis. Surgery is necessary only when tonsillitis recurs frequently, does not respond to treatment, or causes complications.


The tonsils are two lymph nodes located in the back of the throat behind the tongue. They are part of the body’s immune system, helping the body filter out bacteria and other germs that enter through your nose and mouth to help keep you healthy.


Tonsillitis is most often caused by a common cold virus, although it can also be caused by a bacterial infection such as group A streptococcus, the germ that causes strep throat. Like colds and strep throat, tonsillitis is spread when an infected child breathes, coughs, or sneezes and another child inhales the infected droplets in the air or comes into contact with them on the skin or an object that touches the eyes, nose or mouth.


Symptoms of tonsillitis usually appear about 2 to 5 days after a child is exposed to the virus or bacteria. The most common symptoms include:

• Sore throat
• Difficulty swallowing
• Fever
• Ear pain
• Headache
• Stomach ache
• Red, swollen tonsils
• White or yellowish patches on the tonsils


A doctor can diagnose tonsillitis by examining your child’s throat, ears and nose. The lymph nodes may be swollen and tender while the tonsils are red with white or yellow spots on them. The doctor may also swab your child’s throat to check for streptococcal bacteria. If the test is positive, then your child has a bacterial infection; if the test is negative, then your child’s tonsillitis is viral.


Tonsillitis usually goes away on its own, without treatment, within two weeks. Your child’s doctor will prescribe antibiotics only if your child’s tonsillitis is caused by a bacterial infection (antibiotics cannot treat a virus). If your doctor does prescribe antibiotics, be sure your child finishes the entire dose as prescribed. To help ease your child’s sore throat, have him or her:

• Gargle with warm salt water
• Drink warm tea
• Suck on popsicles

Take acetaminophen (Tylenol) or ibuprofen to lower fever – never give aspirin to a child, as it can cause a serious condition called Reye syndrome


Children who have frequent bouts of tonsillitis that interfere with daily functioning may require surgery to remove the tonsils. This simple procedure is typically performed in an outpatient surgery center and your child will go home a few hours after the procedure. Complete recovery takes about 1 to 2 weeks.

Although tonsillectomy is still the most common surgery among children, it is not done as often as it was in the past because children usually outgrow tonsillitis. That is, it occurs less frequently as children get older. Your pediatrician can help you decide whether your child truly needs a tonsillectomy.


To prevent the viruses and bacteria that cause tonsillitis and other childhood ailments, teach your child proper hygiene:

• Make sure your child washes his hands frequently, especially after going to the bathroom and before eating.

• Teach your child to cough or sneeze into a tissue or her elbow and to use a tissue when wiping her nose.

• Tell your child not to share food, cups or utensils with other children.

• Use disposable antibacterial wipes and hand sanitizer in public places where soap and water are not available.

Am I at Risk

Young children of preschool age to the mid-teen years are most susceptible to tonsillitis. Coming in contact with another infected person is the main risk factor for tonsillitis.


Frequent tonsillitis may cause the tonsils to become enlarged, which can lead to complications such as:

• Difficulty breathing
• Disrupted breathing during sleep (obstructive sleep apnea
• Infection that spreads into surrounding tissue or forms an abscess

If tonsillitis is caused by the strep bacteria and is not treated with antibiotics, complications (although rare) may include arthritis or rheumatic fever.