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Pharyngitis / Tonsillitis

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What is pharyngitis and tonsillitis?

Pharyngitis and tonsillitis are infections in the throat that cause inflammation. If the tonsils are primarily affected, it is called tonsillitis. If the throat is primarily affected, it is called pharyngitis. A child might even have inflammation and infection of both the tonsils and the throat. This would be called pharyngotonsillitis. These infections are spread by close contact with other individuals. The majority of pharyngitis cases occur during the winter or colder months.

What causes pharyngitis and tonsillitis?

There are many causes of infections in the throat. The following are the most common infectious agents:

  • Viruses:
    • Adenovirus
    • Influenza virus
    • Epstein-Barr virus (mononucleosis)
    • Herpes simplex virus
    • HIV
  • Bacteria:
    • Group A beta-hemolytic streptococci (GABHS)
    • Neisseria gonorrhea
    • Haemophilus influenzae type b
    • Mycoplasma
    • Chlamydia pneumoniae
  • Fungal infections
  • Parasitic infections
  • Cigarette smoke

What are the symptoms of pharyngitis and tonsillitis?

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; for others, symptom onset is slow. The following are the most common symptoms of pharyngitis and tonsillitis. However, each child may experience symptoms differently. Symptoms may include:

  • Sore throat
  • Fever (either low-grade or high)
  • Headache
  • Decrease in appetite
  • Not feeling well
  • Nausea
  • Vomiting
  • Stomach aches
  • Painful swallowing
  • Visual redness or drainage in the throat

How are pharyngitis and tonsillitis diagnosed?

In most cases, it is hard to distinguish between a viral sore throat and a strep throat based on physical examination. It is important, though, to know if the sore throat is caused by GABHS, as this requires antibiotic treatment to help prevent the complications associated with these bacteria.

As a result, most children, when they have the above symptoms, will receive a strep test and possibly a throat culture to determine if it is an infection caused by GABHS. This usually involves a throat swab (called quick tests or rapid strep tests) in the doctor's office.

This may immediately become positive for GABHS and antibiotics will be started. If it is negative, part of the throat swab will usually be kept for a throat culture. This will further identify, in two to three days, if there is any GABHS present. Your child's doctor will decide the treatment plan based on the findings.

What is the treatment for pharyngitis and tonsillitis?

Specific treatment for pharyngitis and tonsillitis will be determined by your child's doctor based on:

  • Your child's age, overall health, and medical history
  • Extent of the condition
  • Cause of the condition
  • Your child's tolerance for specific medications, procedures, or therapies
  • Expectations for the course of the condition
  • Your opinion or preference

If bacteria do not cause the infection, then the treatment is focused on comfort of your child. Antibiotics will not help treat viral sore throats. Treatment may include:

  • Acetaminophen (for pain)
  • Increased fluid intake
  • Throat lozenges
  • Antibiotics (if the cause of the infection is bacterial, not viral)

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