• Reference Number: HEY1115/2020
• Departments: Emergency Department, Paediatrics
• Last Updated: 18 May 2020

Introduction

Tonsillitis is a common illness of children. The majority of cases in children are caused by the same group of viruses that cause the common cold such as adenovirus and respiratory sncytial virus (RSV). These children generally recover well with no specific treatments.

What symptoms might my child have?

Your child may:

• have a sore throat
• have a fever or high temperatures
• have flu-like symptoms
• have mild difficulty swallowing (especially dry or hard foods)
• feel sick and not feel like eating
• feel more tired than usual
• bad breath
• Illness usually lasts between 3 to 5 days

This is all normal.

More severe symptoms may include:

• swollen, painful glands in your child’s neck
• pus filled spots or streaks on the tonsils
• hoarse voice

What can I do to help my child?

• Use paracetamol and / or ibuprofen to treat your child’s pain
• Make sure they are drinking enough fluids – cool fluids often help
• Your child can eat if they feel like it
• Encourage regular hand washing and cough or sneeze hygiene to prevent the causative infection from spreading

What should I watch out for?

If you have any concerns or notice any of the following within 2 to 3 days please see your child’s doctor urgently or return to the Emergency Department:

• Severe sore throat which rapidly worsens
• Swelling inside the mouth or throat
• Difficulty swallowing fluids or drooling
• Child having difficulty opening their mouth
• Difficulty breathing

What is the usual course of tonsillitis in children?

Most children recover fully with no specific treatments although the doctor may prescribe antibiotics, anaesthetic throat spray or both if they feel that these treatments are necessary.

Certain bacteria can also cause tonsillitis and bacterial causes can be rarely associated with complications, the doctor who reviewed your child will have assessed for features of bacterial tonsillitis and may prescribe antibiotics to reduce the chance of developing these complications.

Current evidence suggests that even bacterial tonsillitis will resolve without antibiotics in the majority of cases. Antibiotics have been found to reduce the length of illness by less than 1 day.

Children may be considered for surgical removal of the tonsils (tonsillectomy) when they have multiple episodes a year.

Current UK recommendations are if a child has had 7 or more episodes of tonsillitis in 1 year or 5 episodes / year for the past 2 years they should be referred to an ear, nose and throat (ENT) specialist. Your doctor will be able to refer a child to ENT if it is appropriate to do so.

General Advice and Consent

Most of your questions should have been answered by this leaflet, but remember that this is only a starting point for discussion with the healthcare team.

Consent to treatment

Before any doctor, nurse or therapist examines or treats your child, they must seek your consent or permission. In order to make a decision, you need to have information from health professionals about the treatment or investigation which is being offered to your child. You should always ask them more questions if you do not understand or if you want more information.

The information you receive should be about your child’s condition, the alternatives available for your child, and whether it carries risks as well as the benefits. What is important is that your consent is genuine or valid. That means:

• you must be able to give your consent
• you must be given enough information to enable you to make a decision
• you must be acting under your own free will and not under the strong influence of another person

Information about your child

We collect and use your child’s information to provide your child with care and treatment. As part of your child’s care, information about your child will be shared between members of a healthcare team, some of whom you may not meet. Your child’s information may also be used to help train staff, to check the quality of our care, to manage and plan the health service, and to help with research. Wherever possible we use anonymous data.

We may pass on relevant information to other health organisations that provide your child with care. All information is treated as strictly confidential and is not given to anyone who does not need it. If you have any concerns please ask your child’s doctor, or the person caring for your child.

Under the General Data Protection Regulation and the Data Protection Act 2018 we are responsible for maintaining the confidentiality of any information we hold about your child. For further information visit the following page: Confidential Information about You.

If you need information about your child’s (or a child you care for) health and wellbeing and their care and treatment in a different format, such as large print, braille or audio, due to disability, impairment or sensory loss, please advise a member of staff and this can be arranged.