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If you need medical advice, please consult your doctor. This website does not replace medical advice, and no guarantees are given as to its accuracy.

 

© Mat Daniel 2019       

Tonsillitis

 

Tonsillitis affects many children and adults. It is a painful infection, with tonsils that are swollen, and look white or angry red. High temperature, bad breath, ear pain, and swollen neck glands also occur. Usually it goes on for a week then resolves.

The following symptoms could suggest complications or other problems, so it is important to seek medical attention if painful swallowing is associated with:

-neck stiffness

-not being able to open the mouth

-loss of voice

-not being able to swallow drinks

-breathing difficulties

Painkillers such as paracetamol and ibuprofen will be helpful, and your

pharmacist can give you advice too. See NHS information.

Glandular Fever

A related problem is Glandular Fever, also known as Infectious Mononucleosis or kissing disease. This is a viral infection caused by the Epstein Barr Virus. Symptoms are similar to standard tonsillitis, but can drag on for a longer time period. It is diagnosed on a blood test. Glandular fever can also cause problems with the liver or the spleen.

Quinsy

 

A quinsy is an abscess around one of the tonsils. It starts as simple tonsillitis, but gets worse and turns in to an abscess. An abscess is where the child gets pus fluid forming around the tonsil. A key feature of a quinsy is difficulty opening the mouth. Treatment may need drainage of the abscess, either with your child awake if they are older and cooperative, or asleep in theatre under general anaesthetic.

Recurrent tonsillitis

Recurrent tonsillitis is defined as seven episodes in one year, or five episodes per year for two years in a row, or three episodes per year for three years in a row. 

Getting a tonsillectomy for recurrent tonsillitis on the NHS

Tonsillectomy is described on a separate page. In the NHS, tonsillectomy is now a restricted procedure, which means that you have to meet specific criteria before NHS will fund surgery. Surgery for recurrent tonsillitis is funded, but many parts of the country will require that every episode of tonsillitis has been documented by a health professional.

 

Now the usual advice for sore throats is to try and manage your child's symptoms at home. But if they are getting tonsillitis, if you manage it at home, it is not documented in their medical notes, and does not count as an episode towards the recurrent tonsillitis number! In the past, ENT surgeons would take your word for the number of episodes. However, now they will usually need to see documented episodes reported by your GP. So if you want to build up a record of recurrent tonsillitis episodes you will need to have them documented by your GP.

If you are getting simple sore throats, the advice to manage without seeing your GP is appropriate. But if you are getting tonsillitis and you think that you may be heading for a tonsillectomy based on the definition of recurrent tonsillitis above, you would be wise to see your GP on every occasion so that the episodes are getting documented in your medical notes.

(Advice is given based on the author's regional NHS funding policy. Other parts of the country may be different, although with NHS funding in crisis we expect similar restrictions will be in place elsewhere).