The two tonsils at the back of the throat are part of the ring of lymph glands that guard the entrance to the respiratory and digestive systems. Very small at birth, they enlarge gradually, reaching maximum size at age 6 or 7 years. Thereafter, they shrink but do not disappear, as adenoids do.

The tonsils are relatively large at early school age, when the respiratory tract begins to be attacked by a variety of new microbes; the tonsils are thought to act to keep the microbes away from the lower respiratory tract. Both tonsilitisand pharyngitis are bacterial or viral infections of the back of the throat that cause soreness, and they are often associated-particularly in children. Sore throats may also be part of a more generalized respiratory infection, such as influenza.

What are the symptoms?
Tonsilitis starts suddenly with sore throat and difficulty in swallowing;within a few hours, the child becomes feverish and may seem quite ill. The painful irritation in the throat makes some children often complain of stomach pain. Glands on either side of the neck and in the angle of the jaw may swell and become tender. They can be felt as small, knob-like protuberances. Sometimes , the swellings persist for several weeks after the main symptoms have subsided.

How common is the problem?
Virtually every child has one or more attacks of tonsillitis which is very contagious. Frequent attacks of tonsillitis, which is very contagious. Frequent attacks usually lessen after age of 7 years as resistance develops.

What are the risks?
Before the advent of antibiotics , tonsillitis could lead to rheumatic fever or some form of glomerulonephritis, but such complications are rare today.

What should be done?
Try the self-help measures recommended in the next paragraph. If the child is clearly uncomfortable, consult your doctor, who will examine the child’s tonsils and determine whether the condition is present.

What is the treatment?
Self-help the child should be kept indoors 9but not in bed, unless he or she request otherwise) in a warm-not overheated-room. Symptoms can usually be relieved by giving paracetamol and plenty of fluids, which should be sipped regularly. Don’t force the child to eat or drink. If he or she asks for cold desserts to cool the throat, there is no harm in giving these. Frequent sponging of the face with tepid water may comfort the child . in most cases, children with tonsillitis responds swiftly to these measures.

Professional help the doctor will probably prescribe an antibiotic drug; ensure your child takes the full course as instructed. The tonsillitis should clear up in a few days.
If attacks of tonsillitis are so severe and frequent that they affect general health, then surgical removal of the tonsils may be the only answer. This operation was performed frequently in the past but most doctors today recommend it only as a last resort. Severe sore throats with similar symptoms when the tonsils have already been removed can clearly not be tonsillitis and are more likely to be pharyngitis.(taken from EPN Consultant Books

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