Tonsillitis in children – causes, symptoms and treatment


tonsillitis in children is an infectious-inflammatory process involving the Palatine tonsils. The disease can actively affect children when they reach two years of age and for a period of 5 years – 10 years, peak incidence tonsillitis. But this does not mean that if a child of 4 years, the probability of developing the disease is small, and you don't have to worry. In General, there are known cases of development tonsillotomy conditions and for year-old babies. But "full" tonsillitis develops if the tonsils is formed in the child. 2 years – just the age when the anatomical structure takes on its full form.

Тонзиллит - инфекционное заболевание, которое характеризуется воспалением небных миндалин
Tonsillitis is an infectious disease that is characterized by inflammation of the tonsils

Code according to ICD 10 (international classification of diseases) of the disease – J03 acute forms, while chronic tonsillitis in the child, the doctor will refer to as the J35.

Both bacterial and viral tonsillitis in children is characterized by a rather heavy feeling. It is almost always accompanied by intense pain in the throat, tonsillitis temperature increases (however, the course of the disease without fever in a child is possible).

Acute tonsillitis caused by bacterial infectious agent, called sore throat. As the causative agent in this case is often beta hemolytic Streptococcus. Its symptoms differ from those with chronic disease.

Please note! How to treat tonsillitis in the acute form? The process you need to stop the drug antibacterial drugs prescribed by a doctor. ANDotherwise you risk not only not to cure tonsillitis, and "switch" the disease into a chronic form to heal which is much harder to have a child. Treatment at home is possible, but be sure to comply with all recommendations of the children's consultation!

So, there are acute and chronic tonsillitis. Treatment should in both cases be appointed as an otorhinolaryngologist. Antibiotics to treat tonsillitis in children is almost always appointed, and folk remedies can be used only as a Supplement to the main line of traditional therapy.

Important! Do not try to treat chronic tonsillitis in children independently of traditional methods! How to treat chronic tonsillitis depending on the nature and pattern of the disease, shall be settled exclusively by the doctor whose recommendations should be strictly implemented!

Why is he developing?

The Palatine tonsils (which are also often referred to as "the tonsils") is a lymphoid paired anatomical structures, which are located in between the two arches of the palate in the oral cavity at the rear pharyngeal wall. Tonsil is a protective barrier number one, with which the pathogens are faced with the penetration into the body of the child. The main "duty" of the tonsils is to prevent further progress of viruses and bacteria and the establishment of local immunity. Said body has a porous structure and a 10-15 lacunae (gaps).

Tonsillitis pictures of throat of the child:

При тонзиллите у детей воспаляются и увеличиваются в размерах миндалины
When tonsillitis in children and inflamed tonsils are increasing in size

Sometimes when the penetration of the infectious agent in the body tonsils are unable to repel the attack and are affected by pathogenic microorganisms. It can be:

Then the tonsils increase in size, become edematous and inflamed, lose their protective properties – developing tonsillitis.

Infection of the child by pathogenic pathogens occurs mainly by airborne droplets (through cough and sneezing), and after using shared toys, hygiene items, kitchenware. Therefore most likely to infect those children who go to kindergartens, nursery groups, schools, and visit public places with large crowds. In addition, tonsillitis can be formed independently, when the child's body is weakened and opportunistic or pathogenic microorganisms that live on mucous membranes, begin to multiply rapidly. This, for example, can occur after hypothermia or due to the development of immunodeficiency States of various origins.

symptomatology of the disease

Acute tonsillitis, as, however, and exacerbation of chronic diseases, is accompanied by certain symptoms:

  • the temperature rise that can reach high numbers, about 40°C, chills, fever;
  • pain, a sensation of tingling, tickling and dryness in the throat which amplify when swallowing and yawning;
  • every patient's mouth unpleasant smells;
  • child complains of headache;
  • tonsils increase in size, turn red and swell, in some cases, it is accompanied by the formation of suppurative abscesses or plaque on them;
  • the voice disappears or hipnet;
  • observed drowsiness, lethargy, the child is naughty;
  • some children have disturbed sleep;
  • lost appetite;
  • submandibular lymph nodes increase in size;
  • appears dry cough;
  • disturbed digestion, abdominal pain appear;
  • child plagued by nausea and sometimes vomiting, as the body is in a state of intoxication;
  • in some cases may have convulsions.

Suppurative tonsillitis in children photos throat toddler 3 years:

Гнойный тонзиллит у ребенка 3 года
Suppurative tonsillitis in a child of 3 years

The symptoms and treatment for chronic tonsillitis differ from those in the acute form of the disease. Toddler complains of intermittent pain of moderate intensity, or to a vague discomfort in the throat. Also he has a putrid odor from the mouth, the temperature is within the low-grade fever, the child is easily tired, lethargic, he had a recurring dry cough.

Aggravating factors in the development of tonsillitis can be:

  • viral infectious agents (Rhino-, adeno-, enteroviruses, and viruses of herpes infection, influenza, and parainfluenza);
  • of violation (mechanical, etc.). nasal breathing,sinusitis, adhesions in the nasopharynx;
  • occurs in the mouth inflammation (it can be stomatitis, dental caries, periodontitis, etc.);
  • hypothermia;
  • adenoidit;
  • stress factor;
  • eating disorders;
  • hypovitaminosis;
  • the specific structure of the lymphoid apparatus of the throat (narrowed deep lacunas of tonsils, a large number of slit-like moves);
  • the loose structure of the tonsils in chronic inflammatory process.

Please note! The groupsit is risk are those childrenwho have a history of perinatals pathologistsand, body structure violationspredisposition genetic characterthe tendency to Allergycal reactions and reduced immunity.

types of tonsillitis

Тонзиллит у детей может быть острым или хроническим. Острая форма имеет ярко выраженные симптомы
Tonsillitis in children can be acute or chronic. The acute form has pronounced symptoms

The disease, as already mentioned, is chronic and acute. In acute inflammation, the clinical picture is expressed quite clearly.

The character of inflammation, tonsillitis is divided into:

  1. Catarrhal. The tonsils are enlarged, regional lymph nodes are enlarged. On congested tonsils present whitish serous plaque.
  2. Fibrinous. Tonsils covered with a whitish bloom, similar to film.
  3. Lacunar. Tonsils enlarged, edematous, hyperemic, regional lymph nodes also enlarged, the gaps present purulent plaque yellowish.
  4. The follicular. Strongly hyperemic tonsils, under the superficial layer of lymphoid tissue are pinpoint spots (follicles) with purulent contents.
  5. Gangrenous. At the back of the throat, the formation of gray-white coating and ulcers in the tonsils are observed ulcerous-necrotic changes.
  6. Abscess. Tissue of the tonsils are inflamed, produces unilateral or bilateral abscess.

Chronic tonsillitis is called in the case when the disease manifests more often than twice a year. The main reason for its development – and undertreated "healed" acute, recurrent angina and the lack of prevention of tonsillitis in children. Catalysts are chronic inflammatory diseases of nasopharynx and oral cavity, frequent viral respiratory infections and acute respiratory infections. The tonsils become foci of chronic infection. Often in the cold season in children exacerbation occur, they are usually in autumn and winter, and generally during periods of seasonal fall in immunity, and under the influence of sub-zero temperatures.

The nature of chronic tonsillitis are:

  1. Compensated. Symptoms of chronic local inflammation (swelling, redness, enlarged tonsils), there is a partial loss of their barrier function.
  2. Decompensated. There is a significant reduction in the barrier function of the gland, often develop angina with abscess. In addition to local inflammatory reactions may develop inflammation of the sinuses, and sometimes affects internal organs.

With chronic tonsillitis the gland is gradually destroyed (or grows, being replaced by connective) lymphoid tissue.

That is, there is a place or

  • Atrophic tonsillitis ("shrinkage" of the tonsils) or
  • Hypertrophic tonsillitis (abnormal overgrowth).


If you do not hold adequate for proper treatment and to prevent the transition of the inflammatory process in chronic, it can be fraught with complications. Many of these processes can pose significant danger to the child's health and even end his or her disability.

Local complications of type experts include:

  • Two types of abscesses that extend beyond the tonsils – peritonsillar and parapharyngeal;
  • Ulceration of the tonsils with subsequent bleeding from the latter;
  • Infection and inflammation or suppuration of the surrounding anatomical structures (sinusitis and sinusitis, and inflammation of the middle ear and eustachia);
  • Asphyxiation due to lung edema of the larynx representing a danger to life;
  • Sepsis tonsillitis and character.

Complications common, gradually developing and relating the whole body include:

  • Thyrotoxicosis;
  • Involvement of the renal glomerular apparatus (glomerulonephritis);
  • Infectious myo - and endocarditis;
  • Pneumonia recurrent nature;
  • rheumatoid arthritis and hemorrhagic vasculitis;
  • Acquired heart diseases;
  • Bronchiectasis;
  • Psoriatic and eczematous lesions, and exudative erythema.
При тонзиллите у ребенка может возникнуть такое осложнение, как экссудативная эритема
When tonsillitis, the child may experience complications such as exudative erythema

Important! For order to be able to control appearance complications of diagnosed in a child chronic tonsillitis should be on regularlythe basis to visit the doctorrheumatologist; and do not neglect a visit to cardiologistin, to those skilled in the kidney - nephrologistin and other highly specialized doctors. You should regularly tests, to an embryonic stage identified abovenotwithstanding that dangerous pathology.


When there is suspicion that the child develops tonsillitis, you need to go to ENT doctor or pediatrician to confirm or refute the diagnosis further establishing its varieties. If the child's condition is severe, you should call the doctor at home.

Children's doctor for diagnosis, conducts and assigns:

  • A thorough history with the involvement of parents and the sick baby;
  • inspection with the aid of pharyngoscope or just visually mucous membrane of the throat;
  • palpation of the regional lymph nodes;
  • General (clinical) blood and urine;
  • A swab from the throat to identify the causative agent (so-called "cultures").


To treat tonsillitis a must, and as early as possible. The child's body is fragile, the baby is much harder to tolerate this disease compared to adults. The child suffers symptoms of intoxication, fever, which is hard to bring down. Often children have to be hospitalized.

При остром тонзиллите с повышенной температурой нужно соблюдать постельный режим
In acute tonsillitis elevated temperature is necessary to observe bed rest

During the period of the disease should comply with bed rest, sparing ground to eat mild foods and drink plenty of warm fluids – tea, juice, water, fruit compote. In addition, it is necessary to conduct frequent airing and regularly do wet cleaning in the nursery.


Effective correct and timely treatment of acute tonsillitis makes it possible to preserve the physiological protective function of the affected tonsils. The treatment course which should be chosen depending on many factors a doctor usually includes the following groups of drugs:

  • antibiotics;
  • fever;
  • immunomodulatory drugs and antiviral drugs;
  • local antiseptic and anaesthetic (sprays, solutions, lozenges, etc.);
  • antihistamines;
  • probiotic means.

Antibiotics in acute bacterial tonsillitis are the basis of therapy. They can be administered in oral forms (suspensions, capsules, tablets, syrups) and by injection. Drugs in this group of broad-spectrum presents means, comprising:

  • amoxicillin (with clavulanic acid or without);
  • penicillin;
  • erythromycin;
  • Ceftriaxone;
  • spiramycin;
  • azithromycin.

After the start of antibiotic therapy a significant improvement must occur on the third day of therapy, which must continue up to 7-10 days to prevent chronicity of the process. How to cure tonsillitis for sure? Do not stop taking antibiotics until the end of the course!

Local therapy eases the symptoms of the disease and includes antiseptics like Faringosept, Hexoral, Furatsilina, Iodinol and other local funds. Applications depend on the release form. Very good reviews the drug has not help me plant-based.

Гексорал - эффективное средство местного действия для лечения тонзиллита у детей
Hexetidine is an effective means of local action for the treatment of tonsillitis in children

Related drugs. Dr. Komarovsky as a prophylaxis against antibiotic-associated intestinal disorders recommends probiotics (the Lactobacterin, Linex, Bifidumbacterin etc.).

Appointment of antiviral drugs and immunomodulators it is advisable, when the disease has a viral nature, or formed in conjunction with a viral infection.

Of antipyretic drugs, it is preferable to use a medication based on ibuprofen or based on paracetamol (suppositories, syrups, tablets).

Traditional methods of treatment

Make yourself and give the child with tonsillitis funds, made by people's recipes, only after prior consultation of the specialized doctor. As components of combination therapy is often prescribed rinse with decoctions and infusions of medicinal plants. Soften the throat, antiseptic impact and reduce inflammation such plants as eucalyptus, pharmacy chamomile, sage, Hypericum and calendula.


Good-proven in this field UHF, as well as laser and microwave therapy and phonophoresis. Prevention of exacerbations is including the passing rates of these procedures twice a year. About the complete recovery from chronic tonsillitis can say if there are no complications in the five-year period.


If recurrent angina and in severe cases of chronic tonsillitis, doctors often recommend surgery, which is tonzillacktomii, in other words, the removal of diseased tonsils. It is made for children 3 years and older under local or under General anesthesia.

Indications to Step

  • The lack of results from long-term conservative therapy;
  • The development of pathology of the internal organs as a complication;
  • The formation of peritonsillar abscesses;
  • Inflammation in the oropharynx;
  • Partial or almost complete blockage of the enlarged tonsils of the upper respiratory tract;
  • More than 5 exacerbations in the past 12 months

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Vladimir Orlov - ENT
Author: Updated article: 13.04.2019
I welcome You on pages of my notes in otolaryngology - diseases of the ear, nose and throat (in common doctor - ENT). 9 years of medical practice in private clinics and hospitals in Moscow and St. Petersburg. Share their personal experiences with the readers of my blog, on this medical website give advice on symptoms and treatment of ENT diseases of ear, throat, nose. Be healthy!

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