Children's Health and Wellness

Pharyngitis and Tonsillitis in Children

What are pharyngitis and tonsillitis?

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 either side of 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?

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:

  • Bacteria, such as those that cause strep throat
  • 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

Who is at risk for pharyngitis and tonsillitis?

Viral and bacterial infections are spread by close contact with other people who are sick. For example, kids 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?

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
  • Nausea and vomiting
  • Belly pain
  • Feeling achy and tired
  • Red or swollen throat
  • Red or enlarged tonsils
  • Throat or tonsils 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 his or her healthcare provider for a diagnosis.

How are pharyngitis and tonsillitis diagnosed?

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

Your child may have a rapid strep test. This is a fast test to see if your child has strep throat. It is important to check for strep throat to treat it and prevent complications. Your child may also have a throat culture and sensitivity. This also checks for strep and for the best antibiotic to treat it. It takes a few days to get the results. Blood work may be done to check for infections like mono (infectious mononucleosis).

How are pharyngitis and tonsillitis treated?

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 he or she 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 as a liquid or pills for pain. Other medicines or treatments may be recommended for severe pain.
  • Increasing how much your child drinks. Some teas have ingredients that soothe the throat.
  • Eating smooth, cool foods such as gelatin, ice cream, and ice pops.
  • Gargling with salt water (for older kids). Ask your child’s healthcare provider for instructions.
  • Sucking on throat drops or hard candies (for older kids).

Tonsillitis may also require a hospital stay if enlarged tonsils are blocking the airways. In some children with recurrent tonsillitis, the healthcare provider may recommend that your child have his or her tonsils removed (tonsillectomy). Your child's healthcare provider will likely want you to see an ear, nose, and throat specialist (ENT).

What are the complications of pharyngitis and tonsillitis?

Complications of pharyngitis and tonsillitis are:

  • Serious infections in the throat area
  • Loss of fluid or dehydration in the body from trouble eating and drinking
  • Breathing problems from very large tonsils with tonsillitis

Untreated strep throat may lead to heart and kidney problems, middle ear infection, lung infection, or infection of the covering of the brain and spinal cord.

When should I call my child's healthcare provider?

Call your child's healthcare provider 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

Call 911 or your local emergency number if your child has:

  • Trouble breathing
  • A severe sore throat and has difficulty swallowing or breathing, is drooling, or has a stiff neck or neck swelling

Key points about pharyngitis and tonsillitis

  • Pharyngitis is inflammation of the throat. Tonsillitis is inflammation of the tonsils.
  • Viruses are the most common cause. They do not require 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 difficulty 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 healthcare provider:
  • Before your visit, write down questions you want answered.
  • At the visit, write down the names of new medicines, treatments, or tests, and any new instructions your provider gives you for your child.
  • 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 provider after office hours. This is important if your child becomes ill and you have questions or need advice.
Online Source: American Academy of Otolaryngology Head and Neck Surgery
Online Source: Family Practice Notebook
Online Source: Family Practice Notebook
Online Source: American Academy of Pediatrics
Online Source: American Academy of Pediatrics
Online Editor: Sims, Jane
Online Medical Reviewer: MMI board-certified, academically-affiliated clinician
Online Medical Reviewer: Turley, Ray, BSN, MSN
Date Last Reviewed: 6/26/2015
© 2000-2015 The StayWell Company, LLC. 780 Township Line Road, Yardley, PA 19067. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.