Tonsillitis

Tonsillitis is inflammation of the tonsils — the two oval lumps at the back of the throat. It is very common in children, usually caused by viruses (which settle on their own) or sometimes by bacteria, particularly Streptococcus ("strep throat") — which matters because untreated strep can lead to rheumatic fever and rheumatic heart disease, a major cause of heart valve disease in India.

Symptoms

• Sore throat, difficulty swallowing.
• Red, swollen tonsils, sometimes with white/yellow patches.
• Fever.
• Tender, swollen lymph nodes in the neck.
• Headache, stomach ache (in children), earache.
• Bad breath.
• Loss of voice, tiredness.

Features that raise suspicion of bacterial (strep)

• Sudden high fever.
• White/yellow patches or pus on tonsils.
• Tender neck nodes.
• No cough, no runny nose (viral infections usually have these).
• Red spotted palate.
• Scarlatiniform rash.

Red flags — urgent review

• Severe difficulty breathing or swallowing, drooling, muffled "hot potato" voice — possible peritonsillar or retropharyngeal abscess.
• Severe one-sided throat pain, inability to open mouth fully.
• High fever with neck stiffness, severe headache, rash — get medical review.
• Severe dehydration — unable to drink.

Treatment

• Viral tonsillitis — rest, fluids, warm salt-water gargle, a simple pain reliever for pain/fever. Settles in 3-7 days.
• Strep throat — throat swab (RADT or culture) confirms. A full 10-day course of penicillin or other appropriate antibiotic is standard — finishing the course prevents rheumatic fever. This is one of the most important antibiotic uses in India.
• Abscess — drainage + antibiotics; emergency.
• Recurrent tonsillitis — tonsillectomy considered for 7+ episodes in a year, or 5/year over 2 years, or abscess history.

Why strep really matters in India

Rheumatic fever following untreated strep throat is still a major cause of heart valve disease in Indian adults. A simple antibiotic course in a child with strep throat can prevent heart valve damage decades later. Don't skip antibiotics when they are prescribed for strep; complete the full course.