Pediatric Pharyngitis and Tonsillitis

Pharyngitis is redness, pain and swelling of the throat (pharynx). Tonsillitis is inflammation of the tonsils. The tonsils are a pair of tissue masses on both sides at the back of the throat. They are part of the immune system, the part of the body that fights infection and other disease. Your child may have pharyngitis, tonsillitis or both (pharyngotonsillitis).

Viral and bacterial infections are spread by close contact with other people who are sick. For example, kids attending school or daycare are at risk. This is especially true during the winter months, when most viral and bacterial infections occur.

Pharyngitis can be caused by many things. Viral infections are the most common cause. Tonsillitis is usually from viral or bacterial infections. Other causes include:

• Bacteria, such as those that cause strep throat
• Fungi, such as in those that cause a yeast infection
• Allergies, like hay fever or allergies affecting the nose
• Sinus infection
• Cancers
• Injuries
• Irritants, like cigarette smoke or air pollution
• Stomach acids in the throat

To help keep your child from getting ill:

• Have them practice good hand washing hygiene
• Keep them away from people who have sore throats, colds or other upper respiratory infections
• Don't smoke, and keep your child away from secondhand smoke
• Keep your child up to date on his or her vaccines

Symptoms can occur a bit differently in each child. They can include:

• Sore throat
• Trouble or painful swallowing
• Enlarged, painful neck glands
• Hoarseness or change in voice
• Fever or chills
• Headache
• Ear pain
• Nausea and vomiting
• Belly pain
• Feeling achy and tired
• Red or swollen throat
• Red or enlarged tonsils
• Throat or tonsils may have a whitish discharge
• Trouble breathing or snoring

The symptoms of pharyngitis and tonsillitis can be like other health conditions. Make sure your child sees his or her healthcare provider for a diagnosis.

Your child's healthcare provider will ask about your child’s current symptoms. He or she will check your child's temperature. The provider will examine your child, paying close attention to the ears, nose, throat, and tonsils. Depending on your child’s symptoms, the provider may do a throat culture or blood tests.

Your child may have a rapid strep test. This is a fast test to see if your child has strep throat. It's important to check for strep throat to treat it and prevent complications. Your child may also have a throat culture. This also checks for strep and for the best antibiotic to treat it. It takes a few days to get the results. Blood work may be done to check for infections like mono (infectious mononucleosis).

Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how severe the condition is.

If your child has a bacterial infection, then he or she will be treated with antibiotics. If bacteria are not the cause of the infection, then the treatment will focus on making your child comfortable. Treatment may include:

• Taking acetaminophen or ibuprofen as a liquid or pills for pain. Other medicines or treatments may be recommended for severe pain.
• Increasing how much your child drinks. Some teas have ingredients that soothe the throat.
• Eating smooth, cool foods such as gelatin, ice cream, and ice pops.
• Gargling with salt water (for older kids). Ask your child’s healthcare provider for instructions.
• Sucking on throat drops or hard candies (for older kids).

Tonsillitis may also require a hospital stay if enlarged tonsils are blocking the airways. In some children with recurrent tonsillitis, your healthcare provider may recommend that your child have his or her tonsils removed (tonsillectomy). Your child's healthcare provider will likely want you to see an ear, nose and throat specialist (ENT).

Complications of pharyngitis and tonsillitis are:

• Serious infections in the throat area
• Loss of fluid or dehydration in the body from trouble eating and drinking
• Breathing problems from very large tonsils with tonsillitis

Untreated strep throat may lead to heart and kidney problems, middle ear infection, lung infection or infection of the covering of the brain and spinal cord.

Call your child's healthcare provider if your child has:

• A sore throat, especially if it does not go away in a few days
• A sore throat and other symptoms, such as a fever

Call 911 or your local emergency number if your child has:

• Trouble breathing
• A severe sore throat and has difficulty swallowing or breathing, is drooling, has a stiff neck or neck swelling