Bacterial tonsillitis in children
P
arents of preschool and school-age children are certainly on alert and monitoring news about the spread of various infections in groups and classes. One of the most common is bacterial tonsillitis. Learn more about the type of inflammation it involves, its symptoms, and treatment in this text by Dr. Venera Zahariev Španiček, pediatric specialist.
What is bacterial tonsillitis?
Bacterial tonsillitis is an acute infectious disease caused by the bacterium Streptococcus pyogenes, specifically the beta-hemolytic streptococcus (BHS) of group A. Bacterial or streptococcal tonsillitis spreads very quickly through droplets, mostly via close contact.
Symptoms of streptococcal tonsillitis
Children will develop symptoms very quickly after contact with the pathogen – within 1 to 3 days. Symptoms of streptococcal tonsillitis can include:
Sore throat
Painful swallowing
Headache
Nausea
Vomiting
Abdominal pain
Fever
Redness of the throat and tonsils
Coating on the tonsils
Swelling of the neck lymph nodes
Swelling of the palate and uvula with redness and pinpoint bleeding
Scarlet-like skin rash lasting the first four days, often followed by characteristic peeling of the skin and even nails
Possible Complications of Bacterial Tonsillitis in Children
Complications arise from the spread of inflammation to neighbouring structures, potentially leading to ear infections, sinusitis, peritonsillar abscess, para- and retropharyngeal abscess, or inflammation of the lymph nodes in the neck.
In acute throat and tonsil inflammation, the most common is a peritonsillar abscess, which occurs when the causative agent of tonsillitis spreads beyond the tonsils, creating a localized pus collection. This condition requires surgical drainage as oral antibiotic therapy is ineffective due to the encapsulated nature of the abscess. Along with drainage, antibiotic treatment is common.
Non-suppurative complications of BHS include rheumatic heart disease and post-streptococcal glomerulonephritis (kidney inflammation).
Diagnosing the cause of bacterial tonsillitis and treatment
The treatment of choice is penicillin, administered orally in syrup form in multiple daily doses for 10 days. In severe cases, intravenous administration may be required.
For confirmed penicillin hypersensitivity, macrolide antibiotics such as azithromycin and erythromycin can be used.
In addition to antibiotic therapy, rest, adequate fluid intake, and the use of pain relievers (analgesics) and fever reducers (antipyretics) are necessary. Local antimicrobial solutions and anesthetic lozenges may also be considered.