About this condition
Acute tonsillitis is inflammation of the tonsils. Children may develop painful swallowing, fever, swollen neck nodes and a coating on the tonsils, but many episodes are caused by viruses.
What matters most
White patches and a high temperature alone do not confirm streptococcal infection. One acute episode is also not the same as chronic tonsillitis or a reason to consider removal of the tonsils.
Symptoms and reasons to seek help
Common signs include sore throat, painful swallowing, tiredness, chills, fever, red swollen tonsils and sometimes enlarged neck glands. A clinician also asks about cough, runny nose and whether the child can drink fluids.
Distinguishing similar conditions
Viral and bacterial infections can look similar. The need for a streptococcal test depends on the child’s age and clinical findings. A photograph of the throat is not a reliable basis for choosing antibiotics.
How clinicians investigate
Examination considers the throat, hydration, breathing and severity. A rapid strep test or other testing may be used when the result is likely to change management. Recurrent documented episodes are assessed separately.
Care and important limitations
Care is selected according to the cause and the child’s condition. Antibiotics are ineffective for viral tonsillitis and must not be started using leftovers from a previous illness. Discuss appropriate symptom relief and hydration with a clinician.
When emergency help is needed
Difficulty breathing, noisy inhalation, drooling because the child cannot swallow or rapid deterioration require emergency help: call 103 or 112. One-sided swelling, inability to open the mouth normally or marked dehydration needs urgent in-person assessment.
Related information
Signs and symptoms
Common signs include sore throat, painful swallowing, tiredness, chills, fever, red swollen tonsils and sometimes enlarged neck glands. A clinician also asks about cough, runny nose and whether the child can drink fluids.
Diagnosis and tests
Examination considers the throat, hydration, breathing and severity. A rapid strep test or other testing may be used when the result is likely to change management. Recurrent documented episodes are assessed separately.
Care and treatment approaches
Care is selected according to the cause and the child’s condition. Antibiotics are ineffective for viral tonsillitis and must not be started using leftovers from a previous illness. Discuss appropriate symptom relief and hydration with a clinician.
When to seek urgent care
Difficulty breathing, noisy inhalation, drooling because the child cannot swallow or rapid deterioration require emergency help: call 103 or 112. One-sided swelling, inability to open the mouth normally or marked dehydration needs urgent in-person assessment.
Frequently asked questions
Does every white patch on a tonsil mean strep throat?
No. Examination and, when indicated, testing are needed to establish the likely cause.
Does every child with tonsillitis need antibiotics?
No. Many episodes are viral and will not benefit from antibiotics.
How is acute tonsillitis different from chronic tonsillitis?
Acute tonsillitis is a current episode; chronic or recurrent complaints require review of repeated episodes and the periods between them.
Important information
A medical consultation is needed for diagnosis and treatment recommendations.
Self-treatment can be harmful to your health.
