The tonsils are located at either side of the back of the tongue, attacked to the side walls of the mouth. When healthy they appear pinkish and are part of a chain of small glands (lymph glands) surrounding the back of the mouth and the throat. These act as a protection against infection by tapping the disease causing organisms and therefore preventing their spread round the body. When the tonsils are infected they become enlarged, reddened and are often covered with small white spots indicating beads of pus. The lymph glands in the neck will also become enlarged and tender. These swellings represent the body’s normal response to infection and are a healthy sign that it is fighting and probably coping adequately with the invading organisms. Besides the usual symptoms which it shares with the common sore throat – pain in the throat, difficulty in swallowing and fever – the child may also complain of pain in the stomach due to involvement of the lymph glands in the abdomen though this may sometimes be mistaken for appendicitis.

Treatment

Rest: The child may feel listless and tired. He should avoid getting exhausted and should be encouraged to rest and get extra sleep.

Food: Do not try and force a child to eat if it is not hungry but, if the unwillingness to eat is due to discomfort on swallowing, strong efforts should be made to provide nourishment with suitable appetizing and easily swallowed foods such as jellies, ice cream, fruit puree, etc.

Fluids: Encourage the child to drink. Cold drinks will usually be more acceptable, and fruit juices and milk contain most of the body’s requirements.

Pain relief: Soluble aspirin and Disprin should be taken every four hours in the appropriate dose. Certain lozenges (such as Dequadine or Tyrozets) may reduce discomfort.

Gargles : With aspirin dissolved in water or other suitable preparation. They are effective in easing discomfort and will act as an antiseptic, controlling the infection. Gargling is usually only appropriate for children over five years.

Antibiotics : These may be prescribed by the doctor in the case of acute tonsillitis when there is evidence that the child’s normal body defenses are not coping adequately with the infection.