Tonsillitis and sore throat
Tonsillitis is an infection of the tonsils at the back of the throat. Most sore throats are caused by viruses and get better within a week. Some are caused by streptococcus bacteria and need antibiotics; this matters most in children and young people, because untreated strep throat can lead to rheumatic fever, which can damage the heart.
Symptoms
- Sore throat and pain when swallowing
- Red, swollen tonsils, sometimes with white spots
- Fever
- Swollen, tender glands in the neck
- Hoarse voice and bad breath
- In children: refusing food, stomach pain or vomiting
Causes
- Viruses, including cold and flu viruses
- Streptococcus bacteria (strep throat)
- Spread by coughs, sneezes and sharing cups or spoons
Prevention
- Wash hands often with soap
- Do not share cups, plates or spoons
- Cover coughs and sneezes
- Keep a sick child at home until they feel better
Treatment
- Gargle with warm salt water
- Drink warm fluids and eat soft food
- Paracetamol or ibuprofen for pain and fever
- Antibiotics if a doctor finds strep throat — finish the full course to protect the heart
- Do not start antibiotics or other prescription medicines without a doctor
Common questions
Why does a sore throat in a child sometimes need antibiotics?
If the cause is streptococcus bacteria, a full course of antibiotics prevents rheumatic fever, which can permanently damage the heart valves. A doctor can decide whether this is likely.
When are tonsils removed?
Surgery is considered only when tonsillitis comes back many times a year, or when large tonsils block breathing during sleep. An ENT doctor will advise.