Tonsillitis is an infection of the tonsils at the back of the throat. Most sore throats are caused by viruses and get better within a week. Some are caused by streptococcus bacteria and need antibiotics; this matters most in children and young people, because untreated strep throat can lead to rheumatic fever, which can damage the heart.
Symptoms
Sore throat and pain when swallowing
Red, swollen tonsils, sometimes with white spots
Fever
Swollen, tender glands in the neck
Hoarse voice and bad breath
In children: refusing food, stomach pain or vomiting
Causes
Viruses, including cold and flu viruses
Streptococcus bacteria (strep throat)
Spread by coughs, sneezes and sharing cups or spoons
Prevention
Wash hands often with soap
Do not share cups, plates or spoons
Cover coughs and sneezes
Keep a sick child at home until they feel better
Treatment
Gargle with warm salt water
Drink warm fluids and eat soft food
Paracetamol or ibuprofen for pain and fever
Antibiotics if a doctor finds strep throat — finish the full course to protect the heart
Do not start antibiotics or other prescription medicines without a doctor
Common questions
Why does a sore throat in a child sometimes need antibiotics?
If the cause is streptococcus bacteria, a full course of antibiotics prevents rheumatic fever, which can permanently damage the heart valves. A doctor can decide whether this is likely.
When are tonsils removed?
Surgery is considered only when tonsillitis comes back many times a year, or when large tonsils block breathing during sleep. An ENT doctor will advise.
