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Tonsillitis is inflammation of the tonsils, two oval-shaped pads of tissue at the back of the throat — one tonsil on each side. Most cases of tonsillitis are caused by infection with a common virus, but bacterial infections also may cause tonsillitis.

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What is Tonsillitis?

Tonsillitis is very common, as most people will experience its symptoms at least once in their lifetime. Though most common in children above the age of 3, it can affect people of all ages. 

Regardless of one’s age, their symptoms of tonsillitis are normally characterized by the type and root cause of their condition:

  • Acute tonsillitis: Patients have a fever, sore throat, foul breath, dysphagia (difficulty swallowing), odynophagia (painful swallowing), and tender cervical lymph nodes. Airway obstruction due to swollen tonsils may cause mouth breathing, snoring, nocturnal breathing pauses, or sleep apnea. Lethargy and malaise are common. These symptoms usually resolve in three to four days but may last up to two weeks despite therapy.
  • Recurrent tonsillitis: This diagnosis is made when an individual has multiple episodes of acute tonsillitis in a year.
  • Chronic tonsillitis: Individuals often have chronic sore throats, halitosis, tonsillitis, and persistently tender cervical nodes.
  • Peritonsillar abscess: Individuals often have severe throat pain, fever, drooling, foul breath, trismus (difficulty opening the mouth), and muffled voice quality, such as the “hot potato” voice (as if talking with a hot potato in his or her mouth).


Tonsillitis is rooted in infection by means of a virus (such as the cold, flu, or even a condition stemming from COVID-19) or bacteria (such as group A Streptococcus). 

One can develop these types of tonsillitis as the result of common activities including:

  • Kissing
  • Sharing utensils, food, and/or drinks
  • Coming into close contact with someone who is sick
  • Coming into close contact with someone who has been exposed to another person who is sick
  • Touching a contaminated surface (such as a doorknob, coffee pot handle, refrigerator door, etc.) and then exposing your hands to your nose or mouth
  • Inhaling tiny, airborne particles that are spewed when an infected person sneezes or coughs

Diagnosis and Treatment

Your child will undergo a general ear, nose, and throat examination as well as a review of the patient’s medical history.

A physical examination of a young patient with tonsillitis may find:

  • Fever and enlarged inflamed tonsils covered by pus.
  • Group A beta-hemolytic Streptococcus pyogenes (GABHS) can cause tonsillitis associated with the presence of palatal petechiae (minute hemorrhagic spots, of pinpoint to pinhead size, on the soft palate). Neck nodes may be enlarged. A fine red rash over the body suggests scarlet fever. GABHS pharyngitis usually occurs in children aged 5-15 years.
  • Open-mouth breathing and muffled voice resulting from obstructive tonsillar enlargement. The voice change with acute tonsillitis usually is not as severe as that associated with peritonsillar abscess.
  • Tender cervical lymph nodes and neck stiffness (often found in acute tonsillitis).
  • Signs of dehydration (found by examination of skin and mucosa).
  • The possibility of infectious mononucleosis due to EBV in an adolescent or younger child with acute tonsillitis, particularly when cervical, axillary, and/or groin nodes are tender. Severe lethargy, malaise, and low-grade fever accompany acute tonsillitis.
  • A grey membrane covering the tonsils that are inflamed from an EBV infection: this membrane can be removed without bleeding.
  • Palatal petechiae (pinpoint spots on the soft palate) may also be seen with an EBV infection.
  • Red swollen tonsils that may have small ulcers on their surfaces in individuals with herpes simplex virus (HSV) tonsillitis.
  • Unilateral bulging above and to the side of one of the tonsils when peritonsillar abscess exists. A stiff jaw may be present in varying severity.

Pediatric ENT – New Orleans Sinus Center

Your child’s health is too precious to trust just any pediatric ear, nose, and throat specialist.

In addition to tonsillitis, we offer pediatric ENT services for the New Orleans and Greater New Orleans areas for allergies, recurring ear infections, hearing loss, dizziness, motion sickness, thyroid problems, and more. Handled with the utmost care for children of all ages, New Orleans Sinus Center has your back. 

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