Understanding and treating sore throat in children

1- What Is Tonsillitis?

Tonsillitis is an infection of the throat that causes inflammation of the tonsils. There are two main types of tonsillitis in children:

• Viral tonsillitis: The majority of cases are caused by viruses (such as rhinovirus or adenovirus). It often occurs alongside a cold or respiratory infection.

• Bacterial tonsillitis: In about 20 to 30% of cases, tonsillitis is caused by bacteria, most commonly group A beta-hemolytic streptococcus. This type may require antibiotic treatment to prevent complications.

2- Symptoms of Tonsillitis in Children

The symptoms can vary depending on the child's age and the cause (viral or bacterial). The most common signs include:

• Severe sore throat, often accompanied by difficulty swallowing.

• Moderate to high fever, especially with bacterial tonsillitis.

• Swollen tonsils, sometimes with white spots (in bacterial infections).

• Swollen and tender lymph nodes in the neck.

• Headache, abdominal pain, and vomiting in some children.

• Loss of appetite and irritability, especially in younger children.

Viral tonsillitis may also present with a runny nose, cough, or conjunctivitis, while bacterial tonsillitis typically has more localized symptoms in the throat.

3- How to Differentiate Between Viral and Bacterial Tonsillitis

It can be difficult to distinguish viral from bacterial tonsillitis based on symptoms alone. If in doubt, the pediatrician may perform a rapid diagnostic test (RDT) to detect the presence of streptococcus. This quick test helps determine whether antibiotic treatment is necessary.

4- Treatment of Tonsillitis in Children

Viral Tonsillitis:

• No antibiotics needed: Viral infections resolve on their own with supportive care.

• Symptom relief: Paracetamol or ibuprofen can help reduce fever and relieve pain.

• Rest and hydration: Ensure the child drinks plenty of fluids and gets enough rest.

Bacterial Tonsillitis:

• Pain relief: Use analgesics and antipyretics to manage pain and fever.

• Antibiotics: If the rapid test confirms a bacterial infection, antibiotics will be prescribed. It is crucial to complete the full course, even if the child feels better, to prevent complications.

5- Possible Complications of Tonsillitis

While tonsillitis is generally mild, untreated bacterial tonsillitis can lead to complications, including:

• Tonsillar abscess: A pus-filled collection around the tonsils that may require surgical drainage.

• Acute rheumatic fever: An inflammatory disease that can affect the heart, joints, and nervous system.

• Post-streptococcal glomerulonephritis: A kidney inflammation that can occur after a streptococcal infection.

This is why it is essential to follow the prescribed treatment and consult a doctor if symptoms worsen or persist.

6- Prevention of Tonsillitis

Here are a few simple measures to reduce the spread of infections that cause tonsillitis:

• Hand hygiene: Teach your child to wash their hands regularly, especially before eating and after coughing or sneezing.

• Avoid close contact: Limit close contact with sick children during periods of infection.

• Ventilate and clean the environment: Ensure your home is well-ventilated, and frequently touched surfaces are cleaned regularly.

7- When to Consult a Pediatrician

It is recommended to see a pediatrician if:

• Your child has a high fever (above 38.5°C) or a fever that persists.

• The sore throat is severe and prevents the child from eating or drinking.

• You notice signs of complications, such as very swollen lymph nodes or breathing difficulties.

• Your child's condition does not improve within 48 hours or worsens.

Conclusion

Tonsillitis is a common infection in children, but it can be effectively managed with timely and appropriate care. Whether the tonsillitis is viral or bacterial, a correct diagnosis and treatment will help your child recover quickly and resume their activities in good health.