Recurrent Tonsillitis

Tonsils are tissue on both sides of the back of the throat that help the body fight infection. They trap bacteria and viruses entering through the throat and produce antibodies to fight infection.

Tonsillitis means the tonsils are infected. Tonsils become infected by bacteria or viruses, which causes them to swell.

Frequent or recurrent tonsillitis is generally defined as:

• More than 7 episodes in 1 year
• More than 5 episodes a year during a 2-year period
• More than 3 episodes a year during a 3-year period

Tonsillitis may or may not be contagious, depending on the cause. If the cause is viral or bacterial, it is usually contagious.

If the tonsillitis is caused by a chronic condition, such as sinusitis or allergies, it is likely not contagious.

Patients can be seen by Texas Children's experts in Ear Nose and Throat (Otolaryngology).

Causes & Risk Factors

Causes of tonsillitis include:

• Bacterial infections
• Viral infections

Symptoms & Types

Symptoms of tonsillitis include:

• Inflammation and swelling of the tonsils
• Throat pain or tenderness
• Redness of the tonsils
• Yellow or white coating on the tonsils
• Painful blisters or ulcers on the throat
• Swollen glands in the neck
• Hoarseness or loss of voice
• Headache
• Loss of appetite
• Ear pain
• Trouble swallowing
• Breathing through the mouth
• Fever
• Chills
• Bad breath

Types of Tonsillitis:

• Viral
• Bacterial

Diagnosis & Tests

Your child's doctor will perform a physical examination by:

• Using a lighted instrument to look at your child's throat, ears and nose
• Gently feeling (palpating) your child's neck to check for swollen glands (lymph nodes)
• Listening to your child's breathing
• Checking to see if the spleen is enlarged (as one way to check for possible mononucleosis, which also inflames the tonsils)

Tests that may be done include:

• Rapid strep test
• Throat swab to obtain a culture to test for bacteria

Both of these tests involve swabbing the back of the throat close to the tonsils with a cotton swab. A lab test will determine if bacteria caused the infection. A viral infection will not show on the test, but if bacteria is ruled out then the cause is most likely viral.

Treatment & Care

If the infection is caused by bacteria, your child's doctor will prescribe an antibiotic. Antibiotics are not used to treat a virus. The doctor will recommend at-home care to make your child more comfortable.

This includes ensuring your child:

• Gets plenty of rest
• Drinks warm or very cold fluids to ease throat pain
• Eats smooth foods, such as flavored gelatins, ice cream or applesauce
• Gargles with warm salt water
• Sucks on lozenges that contain benzocaine or other anesthetics if old enough
• Takes over-the-counter pain relievers such as acetaminophen (Tylenol) or ibuprofen (Motrin)
• Uses a cool-air humidifier to eliminate dry air that may further irritate a sore throat, or sit for several minutes in a steamy bathroom

The doctor may recommend surgery to remove the tonsils (tonsillectomy) if your child has:

• Obstructive sleep apnea
• Difficulty breathing
• Previously mentioned number of infections

Living & Managing

Proper hygiene reduces the risk of getting tonsillitis.

Remind your child to:

• Wash hands with hot soap and water, especially when around people who appear to be sick
• Not share a toothbrush with anyone
• Not share eating utensils with anyone
• Not drink after others
• Cover the mouth when coughing or sneezing, preferably using a tissue so germs do not get on her hands

As a caregiver, you can:

• Carry disposable wipes and a hand sanitizer to clean hands and to wipe off shopping carts or other shared items in public places
• Not smoke around your child