Pediatric Tonsillitis

This information is useful for children
A girl gets her throat examined.

Sometimes your child’s sore throat is just a sore throat. Other times, it may be tonsillitis, the medical name for an infection of the tonsils that causes them to swell, making it hard to swallow and leaving the lymph nodes in the neck sore.

Everyone is born with two tonsils, small, oval-shaped glands located at the back of your throat. They contain white blood cells, which help ward off infection; but sometimes, the tonsils themselves can become infected by either a virus or bacteria. The most common cause of bacterial infection in the tonsils is streptococcus pyogenes (group A strep), or strep throat.

Tonsillitis is most common among children between ages 5 and 15, and at Yale Medicine, we have a team of pediatric otolaryngologists (ear, nose and throat specialists) skilled at diagnosing and treating it. Most cases of tonsillitis do not require a tonsillectomy (removing the tonsils), but if surgery is needed, our physicians are experienced in the latest and most advanced techniques.  

Tonsillitis is an infection of your tonsils that can make them swell and give you a sore throat. It’s important to treat tonsillitis, especially if it is caused by the strep bacteria, because strep can lead to rare, life-threatening diseases like rheumatic fever, points out Erik Waldman, MD, director of Yale Medicine Pediatric Otolaryngology.

The tonsils trap bacteria and viruses when they enter the body, which can make them prone to infection. After puberty, the immune system function of the tonsils declines and they tend to shrink in size, which explains why tonsillitis is rare in adults. 

In addition to group A strep, other strains of strep and other bacteria can also cause tonsillitis. Children in school are particularly susceptible to tonsillitis as they are constantly exposed to germs from their peers.

Similar to the tonsils—but located higher in the throat and behind the nose—are the adenoids. The adenoids also help trap germs that enter the body through the mouth and nose and clear away infections. And like the tonsils, they can become inflamed and infected.

The symptoms of enlarged adenoids (called adenoiditis) differ from tonsillitis, Dr. Waldman points out. “Adenoiditis can cause a runny nose and blocked nasal ducts,” he says, in addition to frequent ear infections, sinusitis, hearing problems and upper respiratory infections

Like tonsillitis, adenoiditis can also lead to problems with sleep, says Cecilia Helwig, MD, assistant director of Pediatric Otolaryngology. These problems include obstructive sleep apnea, which causes snoring and gasping for breath during sleep, and occasional hyperactivity during the day.

Many children get both tonsillitis and adenoiditis simultaneously.