What are pharyngitis and tonsillitis in children?

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).

What causes pharyngitis and tonsillitis in a child?

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:

• 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.

Which children are at risk for pharyngitis and tonsillitis?

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

What are the symptoms of pharyngitis and tonsillitis in a child?

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.

• Upset stomach (nausea) and vomiting.

• Belly pain.

• Feeling achy and tired.

• Red or swollen throat.

• Red or enlarged tonsils.

• Throat or tonsils that 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 their doctor for a diagnosis.

How are pharyngitis and tonsillitis diagnosed in a child?

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

Your child may have a rapid strep test along with a throat culture. A rapid strep test 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. The throat culture takes a few days to get the results. This also checks for strep and for the best antibiotic to treat it. Blood work may be done to check for infections like mono (infectious mononucleosis).

How are pharyngitis and tonsillitis treated in a child?

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 they 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 for fever or pain. Do not use ibuprofen if your child is less than 6 months old unless the doctor gave you instructions to use it. Be safe with medicines. Read and follow all instructions on the label. Do not give aspirin to children or teens unless your child’s doctor says it is safe. Aspirin can put your child at risk for Reye syndrome, a rare but serious condition.

• Increasing how much your child drinks. Older children may also like warm chicken soup or drinks with lemon and honey. Don’t give honey to a child younger than 1 year old.

• Eating smooth, cool foods such as gelatin, ice cream, and ice pops.

• Gargling with saltwater (for older children). Ask your child’s doctor for directions.

• Sucking on throat drops or hard candies (for older children).

Tonsillitis may also need a hospital stay if enlarged tonsils are blocking the airways. In some children with tonsillitis that comes back (recurrent), the doctor may advise that your child have their tonsils removed (tonsillectomy). Your child's doctor will likely want your child to see an ear, nose, and throat specialist (ENT or otolaryngologist).

How can you help prevent pharyngitis and tonsillitis in your child?

To help prevent your child from getting ill: 

• Have them practice good hand hygiene.

• Keep them away from people who have sore throats, colds, or other upper respiratory infections.

• Keep your child away from secondhand smoke.

• Keep your child up to date on their vaccines.

What are possible complications of pharyngitis and tonsillitis in a child?

Problems from pharyngitis and tonsillitis include:

• Serious infections in the throat area.

• Fluid loss (dehydration) in the body from trouble eating and drinking.

• Breathing problems from very large tonsils with tonsillitis.

Strep throat that is not treated may lead to:

• Heart and kidney problems.

• Middle ear infection.

• Lung infection.

• Infection of the covering of the brain and spinal cord.

When to contact your child's doctor

Contact your child's doctor 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.

Key points about pharyngitis and tonsillitis in children

• Pharyngitis is inflammation of the throat. Tonsillitis is inflammation of the tonsils.

• Viruses are the most common cause. They don't need antibiotics for treatment.

• If bacteria are not the cause of the infection, treatment is focused on the comfort of your child.

• If your child’s sore throat is severe and includes trouble swallowing or breathing, drooling, stiff neck, or neck swelling, call 911 or your local emergency number.

Next steps

Tips to help you get the most from a visit to your child’s doctor:

• Know the reason for the visit and what you want to happen.

• Before your visit, write down questions you want answered.

• At the visit, write down the name of a new diagnosis and any new medicines, treatments, or tests. Also write down any new instructions your doctor gives you for your child.

• Know why a new medicine or treatment is prescribed and how it will help your child. Also know what the side effects are and when they should be reported.

• Ask if your child’s condition can be treated in other ways.

• Know why a test or procedure is recommended and what the results could mean.

• Know what to expect if your child does not take the medicine or have the test or procedure.

• If your child has a follow-up appointment, write down the date, time, and purpose for that visit.

• Know how you can contact your child’s doctor after office hours and on weekends and holidays. This is important if your child becomes ill and you have questions or need advice.