Pharyngitis and Tonsillitis

Pharyngitis and tonsillitis are infections that cause inflammation and soreness in the throat. When the pharynx, the space between the tonsils and the voice box, is affected, it’s called pharyngitis. When the tonsils are affected it’s called tonsillitis. If your child has inflammation of both the pharynx and the tonsils, it is called pharyngotonsillitis.

These viral or bacterial infections most often occur in the winter and colder months and when your child Is in close contact with other children. Nearly all children will have pharyngitis and tonsillitis at some point during their childhoods.

The symptoms of pharyngitis and tonsillitis depend greatly on the cause of the infection and the person affected. For some children, the onset of symptoms may be quick, while for others, symptom onset is slow. There are several common symptoms, but each child may experience pharyngitis and tonsillitis differently.

Symptoms may include:

• Sore throat
• Fever (either low grade or high)
• Headaches
• Decrease in appetite
• Not feeling well
• Nausea
• Vomiting
• Stomach aches
• Painful swallowing

There are many causes for infections in the throat, but certain viruses and bacteria are the most common.

Common viruses include:

• Adenovirus Infections
• Influenza virus
• Epstein-Barr virus
• Coronavirus

Common bacteria include:

• Group A beta-hemolytic streptococci (GABHS)
• Haemophilus Influenzae
• Mycoplasma pneumonia

It is often hard to distinguish between a sore throat caused by a virus and one caused by bacteria based on a physical examination, yet it is very important to know if a sore throat is a "strep" throat caused by group A beta-hemolytic streptococci (GABHS). ”Strep” throat requires antibiotic treatment to help prevent the complications associated with these bacteria.

As a result, when children have tonsillitis or pharyngitis symptoms, they receive a strep test and throat culture to determine if the infection is caused by GABHS. This usually involves a throat swab, called a quick test or rapid strep test, in the doctor’s office.

If the quick test or rapid strep test is immediately positive for GABHS, your child will receive antibiotics. If the test is negative, part of the throat swab will be kept for a throat culture. This will further identify if there is any GABHS present. This usually takes two to three days. Your child's doctor will decide the treatment plan based on the findings.

If bacteria are not causing your child’s throat infection, the doctor may screen for viral infection.

Treatment may include:

• Acetaminophen and ibuprofen (for pain)
• Increased fluid intake
• Throat lozenges
• Antibiotics (if the cause of the infection is bacterial, not viral)
• Repeated tonsillitis may require a tonsillectomy or tonsillotomy

The Boston Children's Hospital Department of Otolaryngology and Communication Enhancement is the oldest, largest, and one of the most recognized centers for pediatric otolaryngology in the U.S. Our team specializes in caring for infectious and inflammatory conditions of the ear, nose, and throat, including pharyngitis and tonsillitis. Because our focus is children, we have the experience and expertise to offer the very best treatment.