Tonsillitis In Children: These Are The Signs You Should Look Out For

Inflammation of the tonsils is relatively easy to diagnose. In addition to sore throat and difficulty swallowing, coatings on the tonsils and visible redness are indicative of angina.

Depending on the type, treatment is carried out with home remedies, medication, antibiotics or in the form of a surgical tonsillectomy. Failure to treat tonsillitis in a child can result in serious complications.

Tonsillitis In Children As A Painful Clinical Picture

In medicine tonsillitis is also called tonsillitis or angina tonsillitis. This is a very painful inflammation of the tonsils (tonsils). In principle, the disease is highly contagious.

It is transmitted by droplet infection. The incubation period, i.e. the time between infection and outbreak of the disease, is between one and three days. In general medical and pediatric practices, angina is among the 20 most common reasons for a patient presentation. This makes inflammation a fairly common disease.

What Are The Tonsils?

The tonsils are lymphatic organs within the oral cavity and in the area of the pharynx. In their entirety, the tonsils form the so-called lymphatic pharyngeal ring. When speaking of tonsils in general, the palatine tonsils are usually meant.

These are located on the palate, at the rear end. Within the body, the tonsils have an important function. They are responsible for the initial localization of harmful bacteria. Furthermore, they serve as the body’s natural defense against disease.

How Tonsillitis Develops In A Child

In tonsillitis, the large palatine tonsils are particularly affected. In general, this disease is very common. Every year, more than one million people in Germany alone suffer from tonsillitis. Tonsillitis often affects children between the ages of six and twelve.

But younger and older children can also be affected by tonsillitis. It is not uncommon for those affected to suffer from a flu-like infection beforehand, which weakens the immune system. Bacteria and viruses can settle very easily due to the weakened immune system and infect the pharyngeal mucosa, through which they later spread to the tonsils.

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Streptococci Are Often The Cause

In most cases, streptococcus bacteria are the cause of tonsillitis in children. If yellow-white spots, stipples or plaques form on the tonsils, this is a sign of a bacterial infection.

The slabs themselves consist of the dead bacteria and dead cells of the human immune system. In many cases, tonsillitis affects only one side. Rarely, both sides are affected.

Angina Plaut-Vincenti Exclusively In Adults

If several bacteria are responsible for the inflammation at the same time, physicians also speak of Angina Plaut-Vincenti. However, this only affects adults. In this form, an ulcer forms directly on the side of the throat.

The palatine tonsils are conspicuous by a green-gray coating of mucus and are also extremely malodorous. On the other hand, the palatine tonsils are usually absolutely inconspicuous.

You Can Recognize Tonsillitis In Children By These Symptoms

The symptoms of tonsillitis in children are very clear. Those affected suffer from severe sore throats and difficulty swallowing. Often this pain develops within a very short time. In the morning, children may still be very well, while in the afternoon they complain of significant pain.

The palatine tonsils show significant redness. They may also swell considerably and have white-yellowish coatings. Not only the tonsils but also the entire throat shows redness. In the angle of the jaw, the lymph nodes are noticeably enlarged.

Another characteristic symptom is foul breath. The sick children feel relatively weak and usually have a very high fever. However, it is also possible for tonsillitis to occur without fever.

Distinguish Bacterial And Viral Tonsillitis In Children Based On The Symptoms

Inflammation of the tonsils can be caused by both bacteria and viruses. If it is a bacterial inflammation, white spots (pus) on the tonsils are characteristic.

If, on the other hand, the affected person suffers not only from a sore throat but also from a cold and cough, it is often a viral inflammation. If the affected patients are already 15 years or older, fever over 38 degrees, swollen lymph nodes in the neck, a coating on the palatine tonsils, and lack of coughing speak for a bacterial infection.

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Tonsillitis As A Concomitant Of Another Disease

Tonsillitis in children does not necessarily represent an independent clinical picture. It may also be a symptom of other diseases.

Pfeiffersches Glandular Fever

Tonsillitis in children and adults can be a symptom of glandular fever. In this case, the palatine tonsils are covered with a flat, dirty coating. In addition, the lymph nodes in the neck, groin, throat, and jaw angle are markedly swollen.


The extremely dangerous diphtheria is caused by bacteria, most of which also attack the larynx or palatine tonsils. Coatings on the tonsils are grayish-white. Attempts to remove these coatings result in bleeding on the tonsils.

Scarlet Fever

Tonsillitis is typical for scarlet fever. Here, the tonsils appear deep red. They are also covered with purulent stipples. Furthermore, the pharyngeal wall is clearly red in color. The oral mucosa may also be affected by smaller spots. The sore throat is extremely pronounced in scarlet fever.


In herpangina, the palatine tonsils themselves are only moderately affected. Herpangina is caused by viruses. Small blisters form on the mucous membrane in the cheek and throat area, which later burst and leave distinctly painful defects. Other symptoms include fever, fatigue, cough, difficulty swallowing, and sore throat.

Kawasaki Syndrome

An inflammatory vascular disease in children, Kawasaki syndrome can cause a variety of symptoms. Among other things, it can cause tonsillitis in children.

Treating Tonsillitis In A Child

The treatment method of tonsillitis is decided based on the severity. If only a mild sore throat is present, simple home remedies are usually sufficient. However, if it is severe, bacterial tonsillitis in the child, the treating pediatrician prescribes antibiotics.

Surgery is usually only necessary if the tonsillitis is very frequent or chronic.

Possible Home Remedies For Mild Tonsillitis

Mild tonsillitis can develop as part of normal cold and does not necessarily need to be treated by a doctor. Plenty of rest and some home remedies can already provide relief. Throat compresses can be extremely symptom relieving.

Salt solutions for gargling and rinsing the palatine tonsils have also proven effective in this context. It is also important to keep the air in the room as humid as possible and to drink plenty of fluids. Acidic drinks such as juice should be avoided. Food should be only slightly spiced and as cool as possible.

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Medical Treatment For Tonsillitis In Children

If the symptoms of tonsillitis cannot be alleviated by rest and, if necessary, supportive medication such as painkillers, medical advice is urgently advised. This also applies if the sore throat is very severe and tonsillitis in the child is thus clearly pronounced.

The pediatrician examines the throat, ears, mouth and palpates the lymph nodes in the neck and jaw area. With the help of a rapid test, streptococci can be quickly detected via a swab, if they are a possible trigger of tonsillitis.

If the rapid test confirms a bacterial infection, the doctor prescribes an appropriate antibiotic. As a rule, this is penicillin.

Medical Treatment For Virus-induced Tonsillitis In Children

Antibiotics are only effective against bacteria. In the case of virus-related tonsillitis, the treating physician will not prescribe an antibiotic. Viral inflammation is treated symptomatically only.

Accordingly, the doctor will prescribe medication to relieve pain and reduce fever. Home remedies and sparing can significantly accelerate the healing process.

Surgical Treatment Of Tonsillitis In Children

If tonsillitis is chronic or particularly frequent, it may be advisable to treat it by surgery. This usually involves complete removal of the palatine tonsils.

Children have been shown to benefit from such an operation. It has been proven that children are less likely to miss school due to illness after a tonsillectomy.

Duration And Prognosis Of Tonsillitis

The course of tonsillitis in a child is difficult to determine in advance. It generally depends on various factors. The main factors include the type of pathogen, the general resistance of the child, climatic conditions, and the physical condition of the affected person.

Medication, sparing and home remedies can favor the course of an illness. In general, however, it can be said that the symptoms noticeably subside after three to five days. Children with the disease are usually completely free of symptoms after one to two weeks.

Possible Complications Of Tonsillitis In Children

However, tonsillitis can also cause various complications. In addition to angina, sinusitis and middle ear infections often occur. The reason for this is the insufficient ventilation of the eustachian tube or the paranasal sinuses due to the swelling of the mucous membrane.

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In addition, a peritonsillar abscess can occur. In this case, a focus of inflammation encapsulates itself in the area of the pharynx. Those affected suffer from extreme sore throat and can only open their mouth minimally.

Further Complications In The Context Of Tonsillitis In Children

Rheumatic Fever

Rheumatic fever may occur three weeks after streptococcal angina. In this context, the affected person often suffers from fever again. Furthermore, a reddish skin rash may appear. Painful inflammation of the joints is also typical.

If the course is very unfavorable, these inflammations can last for many years. In connection with rheumatic fever, heart inflammations are also possible. Cardiac arrhythmias can occur. The nervous system can also be affected by rheumatic fever, with sudden uncontrolled convulsions.

Inflammation Of The Renal Corpuscles

Six to twelve days after tonsillitis has subsided, the kidneys may become inflamed. This condition is noticeable because of blood in the urine.


If the course of tonsillitis is severe, bacteria may enter the bloodstream and cause sepsis. This is a very severe clinical picture that can lead to complete loss of organ function.

FAQs On The Subject Of Tonsillitis In Children

1. Which Antibiotic Helps With Tonsillitis?

Antibiotics are administered only when a bacterial infection occurs. The drug of the first choice for tonsillitis is penicillin.

2. Which Tonsillitis Is Contagious?

Both viral and bacterial tonsillitis are highly contagious via droplet infections.

3. What Do Home Remedies Help With Tonsillitis In Children?

Home remedies can help the recovery process during tonsillitis in a child. Throat compresses, plenty of rest, plenty of fluids, cool and soft foods are recommended.

4. Which Doctor Is Responsible For Tonsillitis In Children?

In general, the pediatrician in charge is the responsible contact person in case of tonsillitis. In the case of chronic courses, a visit to the ear, nose, and throat specialist is advisable.

5. When Does Tonsillitis In A Child Get Better?

The symptoms usually subside within three to five days. The affected child is completely symptom-free again after one to two weeks, provided no complications develop.

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