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Tonsillitis acuta (Latin name)

By Bjarne Lühr Hansen PhD, MD and Philipp Skafte-Holm MD, Mentor Institute

Most cases of tonsillitis are viral and should not be treated with penicillin. Some cases of tonsillitis are bacterial, for example Scarlet Fever and should be treated with penicillin. If your child has a fever, difficulties with swallowing, dribbles and is hoarse you must call the doctor immediately.

When a child has a sore throat, it is often said to be tonsillitis. Especially children with common cold and influenza complain about a sore throat. Only in every third child, the cause of the sore throat is bacterial and only in those cases penicillin helps.

Tonsillitis begins with a dry throat; later pains arise especially when swallowing. A rise in temperature is common. If you look down the throat, the tonsils are red with white coating. The glands are placed on the side of the throat and often they feel swollen and sore. Tonsillitis is rare with children less than two years old.

A child with Scarlet Fever has tonsillitis, strawberry tongue and a finely dotted red rash. The rash begins in the face and spreads to chest, back and legs. The strawberry tongue appears approximately 4 days after the illness has started. The tongue is red with swollen spots and looks like the surface of a strawberry.

Click here to read about how you evaluate your child


Tonsillitis infects through the air via spit but also from objects the child has touched, for example toys and doorknobs.

Day care:
If the child is treated with penicillin, it can attend day care after two days treatment. The child must be free of fever.


To soothe the pains in the throat you can give the child painkilling medication (paracetamol). Scarlet Fever should be treated with penicillin. Remember that children less than 2 yeas old cannot have medication without directions from a doctor.

What can you do?

If the child does not want to eat because swallowing hurts, it should not be forced but instead encouraged to drink plenty. Some children prefer cold, others warm drinks so you have to feel ones way. It may help to raise the bedhead 15-20 cm with bricks or books so that the child sleeps with the head elevated. To soothe the pains in the throat, you can give the child painkilling medication. If the child has a high fever, you should undress it.

Contact the doctor tomorrow

If the temperature is more than 38,5ºC, the tonsils are red and it hurts to swallow. If you suspect Scarlet Fever.

Contact the doctor immediately

If the child is drowsy (lies completely still in bed and does not want to hear stories or play.) If the child has trouble swallowing, dribbles and is hoarse.