Acquired immunity is a marvel of the human body. As we encounter germs in our environment, our immune systems recognize these pathogens as potentially dangerous and fights them off through the creation of antibodies that may prevent future infection. This is great for protecting the body long term, but in the moment, encountering any number of viruses and bacteria can result in feeling lousy. This is especially true for kids whose immune systems are still developing the immunities that will protect them later in life.
Along the way to becoming an adult, children will often develop tonsillitis as they encounter new germs. Usually caused by a virus, such as any of the common cold viruses or the flu, “tonsillitis is an infection of the tonsils,” says Dr. Jean S. Moorjani, a pediatric hospitalist at Arnold Palmer Hospital for Children in Orlando.
[See: Top Reasons Kids End Up in the Hospital.]
Dr. Dyan Hes, medical director of Gramercy Pediatrics in New York City, says that tonsillitis simply “means an infection of the tonsils. It doesn’t mean that it’s bacterial or viral. It just means that it’s an acute infection or inflammation of the tonsils.”
Causes and Symptoms of Tonsillitis
Moorjani explains that “the tonsils are soft tissue that you can see in the back of the throat,” and are part of the immune system. “The tissue that makes up the tonsils house the cells that help us have a strong immune system.” In young children, the tonsils act as a first line of defense against infection. The U.S. National Library of Medicine reports that “tonsils and adenoids work by trapping the germs coming in through the mouth and nose,” which is a helpful arrangement, Moorjani says, given how young children learn about the world around them. “Think about what a lot of kids do — they put things in their mouths. They’re in close contact with friends at school and they’re in general exposed to more germs overall.”
As kids are growing and developing, the tonsils often end up working hard to keep up with the influx of new pathogens. Therefore, “tonsillitis just tends to be something we see more commonly in kids because of the role the tonsils play in the immune system,” Moorjani says. “After puberty, the role of the tonsils becomes less important,” and they actually shrink in size, a process that begins at around age 6, Hes says. That said, it is possible for adults to develop tonsillitis.
Symptoms of tonsillitis include:
— sore throat, throat pain or tenderness
— swelling of glands
— pain when swallowing
— not wanting to eat or drink
— redness in the throat
— fever
Tonsillitis usually starts with a sore throat. You might also note that your child has some swelling along the sides of the upper throat at the base of the jaw. Pain when swallowing is also a common symptom. If your child is too young to tell you what’s wrong, you might “notice they’re not acting like themselves. They’re being fussy or not wanting to eat or drink as much,” Moorjani says. In those cases, she says you should “reach out to your pediatrician. It’s definitely helpful at all ages to take a good look.”
The primary concern with tonsillitis is that it could be a case of strep throat, though Moorjani notes “not all cases of strep throat equal tonsillitis, and not all cases of tonsillitis are strep throat.” Strep is caused by the streptococcal bacteria, which is common and highly contagious. If your child develops a high fever or can’t swallow, it’s definitely time to visit the pediatrician or your family doctor for further evaluation and care.
During that evaluation, the doctor will likely swab the back of the throat to do a strep test. Moorjani says rapid tests done in the office can return results in five to 15 minutes. If strep is detected, you’ll be given an antibiotic. If the in-office test is negative, the doctor usually then sends out a sample for a more precise test. The results of that test usually take about 48 hours to come back. If strep is detected, antibiotics would be an appropriate treatment.
It’s important that strep be taken seriously and treated appropriately because if it isn’t, it can cause some serious complications. “Untreated strep infection can go on to damage the heart valve,” a condition called rheumatic heart disease, Hes says. “Everyone has a grandparent who had rheumatic heart disease because there were no antibiotics. That can lead to needing a valve replacement as an adult.”
[See: 10 Concerns Parents Have About Their Kids’ Health.]
What Are Risk Factors of Tonsillitis?
A rarer complication of strep is a condition called “post-streptococcal arthritis, which is an inflammation of the joints, often in the hip, after an untreated strep infection,” Hes says. Still, even if strep is treated appropriately, there is a rare possibility of developing a kidney disease called post-streptococcal glomerulonephritis. “Somebody might have strep infection and get antibiotics. They might be fine but then suddenly they’re peeing reddish-orange urine. That’s from the damage from the strep. It doesn’t mean your doctor did a bad job, it just happens sometimes, but it’s very rare,” Hes says. The Centers for Disease Control and Prevention reports that PSGN is not contagious “because it is an immune response and not an infection,” but that the strep infections that can trigger this condition are highly contagious.
Hes says it’s unusual for children under the age of 3 to be diagnosed with strep. “The risk factors are being in daycare or having a sibling who has it.”
Moorjani says cases of viral tonsillitis typically take a week to 10 days to clear up, “which anyone with a child knows can seem like an eternity. But just do the best you can to make do and understand your child may not want to eat like they normally do. We recommend trying to keep them well hydrated,” and giving soft or cold foods such as smoothies, which will cool the throat and may be easier to swallow.
With both viral and bacterial cases of tonsillitis, it’s important to get plenty of rest, so staying home from school is usually the best plan for both containing transmission to other children and ensuring your child can get enough rest. Regardless of whether your child’s case of tonsillitis is bacterial or viral, “tonsillitis is contagious,” Moorjani says, so it’s also important to avoid sharing utensils and drinking cups or mugs. “You also want to remember to replace your child’s toothbrush after they’ve been diagnosed, and then again after treatment has concluded,” she says, to avoid reinfection.
Treatments for Tonsillitis
Because most cases of tonsillitis are caused by viruses rather than bacteria, there’s often no easy way to cure it immediately. Rather, you’ll just need to wait for the infection to run its course and the immune system to do its job. Although many people assume that a course of antibiotics will knock it out quicker, Hes says this is a mistake. “People want immediate relief, and we know antibiotics cause resistance. To take antibiotics for viral infections just breeds resistance, and when you need the antibiotics to work, they won’t. So if your doctor says you do not have strep throat, do not demand antibiotics because you will get better without them.”
Some things you can do to feel better in the meantime can be:
— rest and make sure you get enough sleep
— drink warm water or tea with honey and/or lemon to soothe your throat
— suck on throat lozenges
— gargle with salt water
— use over-the-counter pain medications and/or fever reducers
[See: 9 Ways to Boost Your Immune System.]
The main goal should be to make your child more comfortable during recovery, Hes says. “You can take acetaminophen or ibuprofen for pain management. You can gargle with salt water. You can use a numbing throat spray or lozenge.” A warm mug of chamomile tea with honey and lemon can also help soothe the sore throat that usually accompanies tonsillitis.
If your child experiences frequent cases of tonsillitis or develops enlarged tonsils that are obstructing breathing or swallowing, it might be time to have them removed. Your doctor can advise you whether surgery to remove the tonsils would help.
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What Is Tonsillitis? originally appeared on usnews.com
