Sore throat - tonsillitis Tonsillitis is inflammation (swelling) of the tonsils. If your child often has a sore throat, trouble swallowing, and ear pain, she may have a problem with her tonsils. So, what causes tonsillitis? The tonsils are small, dimpled, golf ball-like nodes on either side of the back of your child's throat. They normally help to filter out bacteria and other germs to prevent
infection in the body. If the tonsils become so overwhelmed with bacteria from strep throat or a viral infection, they can swell and become inflamed, causing tonsillitis. Your child's doctor will look in your child's mouth and throat for swollen tonsils. The tonsils will probably be red and may have white spots on them. The lymph nodes in your child's jaw and neck may be swollen and tender to the touch. The doctor may test your child's blood for infection. If bacteria are the cause, your child
will probably need to take antibiotics, either in a shot or in pill form. If your child needs to take antibiotic pills, make sure she takes all of the medicine. To comfort your child, give her cold liquids and popsicles. Gargling with salt water can help. She can also take over-the-counter medicine like acetaminophen or ibuprofen for her pain and fever. Tonsillitis usually improves two or three days after treatment starts. The infection usually goes away too, but some people may need to take
antibiotics for longer. If your child has a great many repeated infections, surgery may be recommended to remove her tonsils, but this is no longer a common reason to have the tonsils out. The lymphatic system filters fluid from around cells. It is an important part of the immune system. When people refer to swollen glands in the neck, they are usually referring to swollen lymph nodes. Common areas where lymph nodes can be easily felt, especially if they are enlarged, are the groin, armpits (axilla), above the clavicle
(supraclavicular), in the neck (cervical), and the back of the head just above hairline (occipital). Structures of the throat include the esophagus, trachea,
epiglottis and tonsils. Strep throat is the most common bacterial cause of sore throat. Because strep throat can occasionally lead to rheumatic fever, antibiotics
are given. Strep throat often includes a fever (greater than 101 degrees Fahrenheit or 38.3 degrees Centigrade), white draining patches on the throat, and swollen or tender lymph glands in the neck. Children may have headache and stomach pain.
If your child often has a sore throat, trouble swallowing, and ear pain, she may have a problem with her tonsils. So, what causes tonsillitis? The tonsils are small, dimpled, golf ball-like nodes on either side of the back of your child's throat. They normally help to filter out bacteria and other germs to prevent infection in the body. If the tonsils become so overwhelmed with bacteria from strep throat or a viral infection, they can swell and become inflamed, causing tonsillitis. Your child's doctor will look in your child's mouth and throat for swollen tonsils. The tonsils will probably be red and may have white spots on them. The lymph nodes in your child's jaw and neck may be swollen and tender to the touch. The doctor may test your child's blood for infection. If bacteria are the cause, your child will probably need to take antibiotics, either in a shot or in pill form. If your child needs to take antibiotic pills, make sure she takes all of the medicine. To comfort your child, give her cold liquids and popsicles. Gargling with salt water can help. She can also take over-the-counter medicine like acetaminophen or ibuprofen for her pain and fever. Tonsillitis usually improves two or three days after treatment starts. The infection usually goes away too, but some people may need to take antibiotics for longer. If your child has a great many repeated infections, surgery may be recommended to remove her tonsils, but this is no longer a common reason to have the tonsils out. CausesThe tonsils are lymph nodes in the back of the mouth and top of the throat. They help to filter out bacteria and other germs to prevent infection in the body. A bacterial or viral infection can cause tonsillitis. Strep throat is a common cause. The infection may also be seen in other parts of the throat. One such infection is called pharyngitis. Tonsillitis is very common in children. SymptomsCommon symptoms may be:
Other problems or symptoms that may occur are:
Exams and TestsYour health care provider will look in the mouth and throat.
A rapid strep test can be done in most providers' offices. However, this test may be normal, and you can still have strep. Your provider may send the throat swab to a laboratory for a strep culture. Test results can take a few days. TreatmentSwollen tonsils that are not painful or do not cause other problems do not need to be treated. Your provider may not give you antibiotics. You may be asked to come back for a checkup later. If tests show you do have strep, your provider will give you antibiotics. It is important to finish all of your antibiotics as directed, even if you feel better. If you do not take them all, the infection can return. The following tips may help your throat feel better:
Some people who have repeated infections may need surgery to remove the tonsils (tonsillectomy). Outlook (Prognosis)Tonsillitis symptoms due to strep will often get better within 2 or 3 days after you start the antibiotics. Children with strep throat should be kept home from school or day care until they have been on antibiotics for 24 hours. This helps reduce the spread of illness. Possible ComplicationsComplications from strep throat may be severe. They may include:
When to Contact a Medical ProfessionalCall your provider if there is:
ReferencesMitchell RB, Archer SM, Ishman SL, et al. Clinical practice guideline: tonsillectomy in children (update) - executive summary. Otolaryngol Head Neck Surg. 2019;160(2):187-205. PMID: 30921525 pubmed.ncbi.nlm.nih.gov/30921525/#affiliation-3. Wetmore RF. Tonsils and adenoids. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 411. Yellon RF, Chi DH. Otolaryngology. In: Zitelli BJ, McIntire SC, Nowalk AJ, eds. Zitelli and Davis' Atlas of Pediatric Physical Diagnosis. 7th ed. Philadelphia, PA: Elsevier; 2018:chap 24. Version InfoLast reviewed on: 10/2/2020 Reviewed by: Neil K. Kaneshiro, MD, MHA, Clinical Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. Why is one side of my tonsil swollen?A person may experience swelling on just one side of the throat if only one tonsil is infected. People can take antibiotics to treat severe bacterial tonsilitis infections. However, if they experience tonsillitis more than five times in a year, a doctor may recommend surgery to remove the tonsils.
Why is only one of my throat glands swollen?Lymph nodes usually swell in the area near an infection. If you have strep throat, for example, the lymph nodes in your neck may swell. Sometimes only one lymph node will swell, causing a sore throat on one side. In rare cases, swollen lymph nodes may be a sign of a more severe problem, such cancer or HIV.
Should I be worried if one tonsil is swollen?Even if there is no growth but one tonsil is significantly larger than the other (a condition called asymmetrically enlarged tonsil), you should have it examined by an ENT Specialist.
What does a swollen gland on one side of the neck mean?Swollen glands are: often caused by common illnesses like colds, tonsillitis and ear or throat infections. sometimes caused by viral infections such as glandular fever. rarely caused by anything more serious, like cancer of the blood system (leukaemia) or lymph system (lymphoma)
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