Tonsillitis and your child
AS we know, the body is built to protect itself from anything foreign that could harm it. A part of this system relates to two infrequently mentioned masses at the back of the throat called tonsils, which are responsible for helping to fight germs which come through the mouth and throat so that they don’t affect the rest of the body.
And while in most cases they fight off these germs very well, sometimes the tonsils themselves do get infected. This infection is known as tonsillitis.
“The tonsils are fleshy masses or organs located at the back of the throat on both sides. It is made up of lymphoid tissue and is much larger in children than in adults. When they become swollen and inflamed, not only is their work compromised, but it is difficult to eat and drink,” explained Dr Anona Griffith, paediatrician at Gateway Plaza, Old Harbour.
She pointed out that tonsillitis is common and affects all age groups, including small children, and may present in several forms such as:
• Acute, meaning short on onset
• Chronic, meaning longstanding
• Recurrent, meaning occurs and resolves with treatment, then happens again.
The most common cases are acute. Fortunately, the infection usually resolves with pain relief and hydration over a five-day period, but may persist even up to two weeks, and so parents are encouraged to take their children to a paediatrician for treatment.
Common symptoms of tonsillitis include:
•Sore throat
•Pain and difficulty swallowing
•Swelling of the glands or lymph nodes in the neck
•Hoarseness
•Headache
•Ear pain
•Fever
•Coughing.
However, symptoms of the more severe disease include pus on the tonsils, drooling and inability to open the mouth. The airway may also become obstructed, requiring hospitalisation.
“The causative agents of tonsillitis may be viral or bacterial. These are usually airborne or passed from individual to individual. These include EBV (Epstein Barr Virus) which causes infectious mononucleosis or “kissing disease” and is common in small children and adolescents. Common bacteria are streptococcus pneumonia (strep throat). Some individuals are carriers of the bacteria but do not manifest the disease,” Dr Griffith explained.
She underscores that it is important to differentiate between the causative agents based on history, clinical presentation and definitively based on cultures in order to adequately treat and prevent any possible complications.
Dr Griffith warned parents against trying to treat tonsillitis at home. She said the reason for this stems from the possibility of a number of associated complications that could develop as a result of untreated or inadequately treated tonsillitis that could cause further pain and discomfort to children. These include the development of abscess around the tonsils that can extend into the surrounding tissues (quinsy). Imaging such as an ultrasound and CT scan may assist in revealing the extent of the disease.
If tonsillitis is caused by the bacteria streptococcus pyrogens, complications usually occur a few weeks after the initial infection. Among these are:
•Rheumatic fever, which affects the heart and other tissues and may require lifelong therapy.
•Scarlet fever
•Infection of the joints (septic arthritis)
•Acute post-streptococcal infection of the kidneys.
Dr Griffith said that one of the considerations, especially in the case of recurrent tonsillitis, is the decision to do a tonsillectomy. A tonsillectomy is the surgical removal of the tonsils.
“Tonsillectomy is done based on a clinical assessment by the ear, nose and throat (ENT) specialist which takes into account many factors including the number of bacterial tonsillar and/or adenoidal infections over a particular period of time, or recurrence of the disease despite optimal treatment,” Dr Griffith advised.
She said the ENT will also take into account the complications of persistently enlarged tonsils on the patient, which may include difficulty breathing, especially at night.
— Penda Honeyghan
