The difference between tonsillitis and a sore throat?
Nathan Page, MD, is an ear, nose and throat pediatric specialist in Mesa, Ariz.
Question: What is the difference between tonsillitis and a sore throat? At what point does my child need to have his tonsils removed?
Answer: A sore throat caused by a cold will often go away after a few days, or when the cold goes away. Tonsillitis is an infection of the tonsils, and is evidenced by red, swollen tonsils sometimes coated with white, gray or yellow patches. Other symptoms include difficulty swallowing, fever, enlarged or tender lymph nodes in the neck and extreme fatigue or weakness.
Most sore throats or cases of tonsillitis can be treated with extra rest, plenty of fluids, throat lozenges and children's pain medication like ibuprofen (Motrin) or acetaminophen (Tylenol). If the tonsillitis is caused by bacteria such as group A streptococcus ("strep throat"), your physician may prescribe antibiotics. If your child is suffering from frequent tonsillitis your physician may recommend evaluation by an ear, nose, and throat specialist to consider surgery to remove the tonsils.
In January, new guidelines about appropriate use of tonsillectomy in children were published by the American Academy of Otolaryngology-Head and Neck Surgery. These guidelines recommend that surgery should not routinely be performed for children with fewer than seven episodes of throat infection per year, fewer than five episodes per year for two years, or fewer than three episodes per year in the past three years. These numbers are not strict rules, and surgery may be appropriate in children with fewer infections who also have problems with their immune system, multiple antibiotic allergies, very severe infections, or complications such as peritonsillar abscess.
Infection is no longer the most common reason for tonsillectomy to be performed in children. Today, most tonsillectomies are recommended for enlarged tonsils that cause difficulty with nighttime breathing, known as obstructive sleep apnea. This ailment can cause daytime sleepiness, poor school performance, behavioral problems and bedwetting. Surgical removal of the tonsils and adenoids is very effective in correcting the disrupted breathing in most children.
Most tonsillectomies are outpatient procedures, meaning your child can go home the same day as the surgery. Taking pain medication and drinking plenty of fluids are important steps to make sure your child has an uneventful recovery. Full recovery usually takes one to two weeks, though some children feel well in just a few days.
Reviewed March 2011