Tonsillitis in Children
Tonsillitis is inflammation of the tonsils, usually due to viral or bacterial infection. While most cases are mild and self-limiting, recurrent tonsillitis can significantly impact a child’s quality of life. At Dashvanth Healthcare Delhi, our paediatricians manage tonsillitis and advise on when surgical referral is appropriate.
Viral vs Bacterial Tonsillitis
Viral Tonsillitis (Most Common)
- Cause: Adenovirus, EBV (infectious mononucleosis), etc.
- Features: Gradual onset, mild-moderate fever, runny nose
- Treatment: Symptomatic only
Bacterial Tonsillitis (Group A Streptococcus)
- Features: Sudden severe sore throat, high fever, swollen tender neck lymph nodes, pus on tonsils, NO runny nose or cough (CENTOR criteria)
- Treatment: Antibiotics – Penicillin or amoxicillin for 10 days
- Why treat? Prevent rheumatic fever and rheumatic heart disease
Complications
- Quinsy (peritonsillar abscess) – surgical drainage required
- Obstructive sleep apnoea from enlarged tonsils/adenoids
- Rheumatic fever from untreated strep tonsillitis
- Glomerulonephritis
When to Consider Tonsillectomy
Recurrent tonsillitis criteria (Paradise criteria): ≥7 episodes in 1 year, OR ≥5 per year for 2 years, OR ≥3 per year for 3 years. Also indicated for: obstructive sleep apnoea, tonsillar hypertrophy causing swallowing/breathing problems.
Home Management
- Adequate hydration (cold fluids, ice lollies)
- Paracetamol or ibuprofen for pain and fever
- Salt water gargles (older children)
- Antibiotics only if bacterial tonsillitis confirmed or suspected
Expert paediatric tonsillitis management at Dashvanth Healthcare Delhi: 011-41670042
