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When Is a Sore Throat Actually Tonsillitis?

Pediatrician's Office, child getting their tonsils checked.

There are sore throats, and then there are sore throats: You know, the ones that come on suddenly and make it hard to swallow. If that happens to your child, it could be tonsillitis—a condition that occurs when the tonsils (two lymph nodes in the back of the mouth) are red and swollen.

Up to 70% of tonsillitis cases are caused by viruses, including rhinoviruses (which also cause most common colds), influenza virus (the flu) and Epstein-Barr virus. The remaining cases are caused by bacteria, and most likely strep (group A Streptococcus) bacteria.

You can get tonsillitis at any age. Most people will get tonsillitis at least once.

"As long as you have tonsils, they can get infected, and they can get swollen," says Dr. Gene Liu, an ear, nose and throat specialist at Cedars-Sinai Guerin Children's.

The most common symptom of tonsillitis is a sore throat. The pain can range from a mild, scratchy sensation to feeling like there are sharp needles or shards of glass in the back of your throat. Your child might also have a fever or chills, and it could be hard for them to swallow. And young children with tonsillitis might drool, refuse to eat, and act extra fussy.

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Gene C. Liu, MD

Otolaryngology

Gene C. Liu, MD

Otolaryngology
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"As long as you have tonsils, they can get infected, and they can get swollen."


How can you tell the difference between tonsillitis and a sore throat?

It's easy to recognize tonsillitis, says Dr. Liu.

"If you open your mouth and say, 'Ah,' you'll see there's a lump or a little meatball on each side of your throat. Those are the tonsils (not the 'punching bag' in the back that's dangling down the middle)," he explains.

"If they're big and red and covered with yellow and white pus dripping down the surface, that's tonsillitis."



When should my child see a doctor for tonsillitis?

If your child has a high fever or other symptoms that last more than a few days, it's a good idea to take them to their pediatrician. If they're having severe difficulty swallowing, drooling excessively or having trouble breathing, you should seek immediate medical care.

No one can tell you if your child's tonsillitis is caused by a virus or bacteria just by looking at their throat. For that, you need a strep test.

If the cause is bacteria, antibiotics may be prescribed. (Make sure your child always takes antibiotics as prescribed and finishes the prescription.) If your child's tonsillitis is caused by a virus, your doctor will likely prescribe an over-the-counter pain reliever along with plenty of rest and fluids.



When should the tonsils come out?

If your child keeps getting tonsillitis or has a severe case that doesn't respond to treatment, your pediatrician might recommend removing their tonsils (tonsillectomy).

The surgery typically lasts 10 to 15 minutes, and most children go home the same day. This might be the one time a doctor recommends having plenty of ice cream and ice pops on hand.

"Eating anything even remotely salty, peppery, spicy or acidic is going to sting and burn and hurt like heck," Dr. Liu says. "So, you go with bland, soft and cool foods because that's all the patient can get down for a little bit."

On average, young children recover from a tonsillectomy in about two weeks, and teens and adults need about three weeks to recover.



Can I get my tonsils removed to avoid tonsillitis?

Dr. Liu says tonsils aren't taken out to prevent tonsillitis.

"If I took out your tonsils, you absolutely would never get tonsillitis. However, it doesn't mean that you would've gotten tonsillitis in the first place," he says. "And because surgery is always serious, we really need a good reason to subject somebody to it."