Almond inflammation in children - baby and family

Tonsillitis in children

Pain when swallowing, fever, the throat is swollen and red – these are typical symptoms of tonsillitis. Which now brings relief to little patients

Just a sore throat or already tonsillitis? Our experts explain how you can tell the difference

Which pathogens trigger tonsillitis?

In most cases, viruses cause tonsillitis. "Sometimes bacteria are also responsible, most often streptococci", says Dr. Ellen Lundershausen, ear, nose and throat doctor from Erfurt and vice president of the German Association of Otolaryngologists. If there is already a viral infection – for example a cold – a bacterial infection can also occur. Doctors then speak of a bacterial superinfection. Untreated, every form of acute tonsillitis is contagious. The pathogens are caused by sneezing and coughing ("droplet infection") transfer.

I can see for myself whether it is a viral or bacterial infection?

"As a layperson, this cannot be distinguished", says Ellen Lundershausen. Yellowish white, purulent deposits, also known as specks, are an indication of bacteria. "Similar deposits also occur, for example, in Pfeiffer’s glandular fever, which is triggered by viruses", says the expert. Therefore: if you have a severe sore throat, be sure to go to the doctor and have the cause clarified, especially if other symptoms such as fever appear. With a throat swab, doctors can determine whether streptococci, for example, are responsible for the inflammation.

Why is it so common for some people?

It is not unusual for children to have tonsils several times a year. "The tonsils are part of the lymphatic pharynx ring and have a defense function", explains expert Lundershausen. Your task is to intercept and fight pathogens in the throat. Since the immune system still has to mature after birth, the body does not always succeed in rendering pathogens harmless in childhood. But even in adults, the tonsils are still susceptible to infection. "When you look through the microscope, its surface appears to be furrowed, one speaks of so-called crypts", said the otolaryngologist. Germs are often deposited in these furrows. But why the one never has tonsillitis ("tonsillae", Latin for almonds) and the other five times in one year has not been scientifically clarified.

Do I have to take an antibiotic for every tonsillitis??

Not necessarily. "If someone comes to me with a sore throat, I first ask if there are other symptoms such as runny nose, cough, headache or body ache", says Sebastian Pape, pharmacist from Hanover. "If this is the case, it is often a viral infection that heals on its own." However, this can only be determined by the doctor, who has to examine the patient thoroughly in order to make a diagnosis. If viruses are really the cause, gargle solutions, pain relievers or lozenges with a slightly anesthetic effect are sufficient, which also stimulate the flow of saliva. Important for the lozenges: They are only suitable for children who can already suck. Otherwise there is a risk of choking! Severe pain, especially when swallowing, often accompanied by a fever, is more likely to indicate a bacterial infection. Ellen Lundershausen decides on a case-by-case basis, even in the case of bacterial infections, whether an antibiotic is really necessary. "Pain relievers are often sufficient for mild tonsillitis", she says. In children, pay attention to the age-appropriate dosage!

Which home remedies relieve swallowing problems?

Gargling with salt water is a simple, but effective method for easier courses, says Sebastian Pape: "Put a teaspoon of salt in a cup of lukewarm water, gargle several times a day, and most importantly, spit it out." Salt pastilles have a similar effect, and there is also a sugar-free version for older children who can already suck. It can also be beneficial to gargle with chamomile tea – if there is no allergy to chamomile. "For external use, for example, curd wrap has proven itself, which cools comfortably", so Pape. To do this, spread the curd thinly on a cloth and place it gently around the neck from ear to ear for about 20 minutes.

When does the disease actually become chronic??

According to the current guideline, the term used earlier is "chronic tonsillitis" not correct anymore because the almond tissue is naturally in a permanent physiological inflammatory reaction due to its defense function. "Today we speak of a recurrent, recurring infection if more than five to six purulent, febrile inflammations occur per year", explains Lundershausen.

When is the operation going on??

Surgical removal of the tonsils (also called tonsillectomy) is one of the most common surgical procedures in children and adolescents. It is carried out in around 48 out of 10,000 children. "However, doctors today usually wait for young children, as the vulnerability can grow", says the specialist. Surgery is only performed before the third birthday if the enlarged tonsils restrict the child’s breathing or if there is an intolerance to antibiotics.

If there are more than six purulent inflammations a year, surgery is at least an option for both children and adults. However, because the procedure causes severe pain and the risk of subsequent bleeding is very high, the guideline recommends a gentler partial removal, also called tonsillotomy. The doctor reduces the tonsils, which also reduces the susceptibility to infections. "Another advantage: the defense function is partially retained", adds Lundershausen.

How do I prevent tonsillitis??

Hygiene measures such as regular hand washing reduce the risk of illness. Important: keep the mucous membranes moist, drink enough and avoid dry heating air. And: Please do not share glasses or water bottles if a family member is sick. Smoking, even passively, can increase susceptibility.

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