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November 17, 2025
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Last updated: 17/11/2025
Tonsillitis in children is one of the most common throat infections. It usually appears after a viral or bacterial infection that causes sore throat, difficulty swallowing, and fever. Although most cases are mild and improve quickly, some children go through difficult days where they feel tired, lose their appetite, and have very low energy.
Many parents describe the first hours of illness as the hardest: a child who cannot sleep well, a sudden rise in temperature, and constant worry. At Magrabi Hospitals, we fully understand these concerns and strive to provide clear guidance that helps parents understand the condition and manage it with confidence, ensuring the child’s comfort and starting the right treatment at the right time.
When a child becomes ill, parents often feel as if their whole day has stopped. If you are now looking for the best way to help your child, it is perfectly okay to seek specialist support.
At Magrabi Hospitals, we welcome children with care and attention to provide them with calm, reassuring medical care during these moments.Book an appointment for your child now
The tonsils are two small glands located at the back of the throat. They act as a first line of defense in the immune system of children, helping to fight viruses and bacteria that enter through the mouth or nose. When the tonsils become infected, tonsillitis in children occurs. It is a common infection that can affect different ages but is particularly frequent between 3 and 10 years.
The infection may be viral, which is the most common type, or bacterial, such as streptococcal infection. In both cases, the infection leads to swollen tonsils in children, sore throat, difficulty swallowing, and possibly fever.
Children develop a number of characteristic signs that help parents notice tonsillitis early. These signs will be explained in the following section on the symptoms of tonsillitis.
The symptoms of tonsillitis in children usually appear clearly and often begin with a sore throat that becomes worse with swallowing, then progress during the day. The most common signs include:
Younger children may not be able to express the pain, but parents may notice crying during meals, reduced appetite, or disturbed sleep. Recognizing these signs helps parents and doctors differentiate between the different types of tonsillitis.
The American Academy of Pediatrics (AAP) indicates that approximately 70% of throat infections in children are viral, while bacterial infections account for around 30%, which explains the differences in symptoms and treatment approaches.
Tonsillitis in children occurs due to an infection that affects the tonsil tissue. The infection may be viral, which is the most common, or bacterial, especially Group A Streptococcus. The main causes include:
In many cases, parents find it difficult to distinguish between viral and bacterial tonsillitis. This makes medical diagnosis an important step in choosing the appropriate treatment and avoiding unnecessary use of antibiotics. At Magrabi Hospitals, our doctors provide accurate assessment that helps parents understand their child’s condition with confidence and start the right treatment.Book an appointment for your child now
Treatment of tonsillitis in children depends on the cause of the infection—viral or bacterial—and the severity of the symptoms. In most cases, the infection is mild and can be relieved at home using safe and effective steps. Some cases, however, require medical evaluation to determine the need for antibiotics or additional treatment.
Home treatment is the main step in cases of viral tonsillitis, which is the most common. Its goal is to relieve pain and support the child’s immunity so that the body recovers naturally. However, it is important to note that some herbal drinks are not suitable for all ages, and the age limits will be explained in detail in the next section.
1. Warm, soothing fluids for the throat
These help moisten the throat and reduce pain, including:
Important note: Age limits must be strictly followed when using herbs and natural drinks, especially for children under 3 years, to prevent irritation or unwanted side effects.
2. Soft and easy-to-swallow foods
Such as:
1. Age-appropriate fever reducers
Such as paracetamol or ibuprofen according to the recommended dose for the child’s age and weight.
2. Rest and good sleep
This helps the body recover more quickly.
3. Humidifying the air
Using a humidifier or warm steam to reduce throat discomfort and dryness.
4. Saline nasal spray
This helps relieve nasal congestion and improve breathing, especially in viral infections.
This type of treatment is used in cases of viral tonsillitis, which do not respond to antibiotics. However, it is essential to strictly follow age limits when using herbs and natural drinks.
1. Age-appropriate herbs for children
For children under one year (0–12 months):
For children aged 1 to 3 years:
• Very mild and diluted herbs such as:
– Very weak chamomile
– Very weak anise
• Once or twice a day only
• Concentrated lemon is not allowed
For children over 3 years:
• It is possible to use safe natural herbs such as:
– Chamomile
– Anise
– Mild thyme
– Warm drink with honey (for children over one year only)
1. Gargling with salt water (over 6 years only)
Children younger than this age may swallow the solution instead of gargling, so it is reserved for older children.
2. Warm compresses on the neck
These are safe for all ages provided they are warm, not hot.
3. Supporting the immune system
Antibiotics are used only when bacterial tonsillitis is confirmed, especially tonsillitis caused by Streptococcus (Strep A). The doctor determines this through direct examination or a throat swab.
Signs that suggest the need for antibiotics include:
The Saudi Food and Drug Authority warns against using antibiotics without a prescription because of the associated risks.
According to the Centers for Disease Control and Prevention (CDC), about 30% of antibiotics prescribed for children are unnecessary, and this misuse contributes to increased bacterial resistance, making future infections harder to treat and potentially leading to serious complications.
Using antibiotics correctly ensures safe recovery and reduces the risk of recurrent tonsillitis.
Some parents resort to unproven methods hoping to speed up recovery, but some of these practices may expose the child to complications. The most prominent of these include:
Avoiding these practices protects the child from complications and helps them recover safely.
In most cases, tonsillitis is mild and improves within a few days. However, there are warning signs that require urgent medical attention to ensure the child’s safety. The most important of these signs are:
When any of these symptoms appear, an ENT specialist should be consulted immediately, as the infection may be severe bacterial tonsillitis or accompanied by complications that require medical intervention. In some recurrent or severe cases, the doctor may recommend considering tonsillectomy, which we introduce in the next section.
Most children do not need tonsil surgery, but it is recommended in certain situations when tonsillitis becomes recurrent or affects breathing, sleep, or the child’s quality of life. Tonsillectomy becomes necessary in specific cases, and the most important medical indications include:
The ENT specialist bases the decision on a comprehensive assessment of the child’s condition, the number of infections, and the severity of symptoms. At Magrabi Hospitals, medical decisions are made carefully to ensure the best possible outcomes for every child.
We will cover “tonsil surgery in children” in detail in a later article, including the steps of the operation, preparation, and recovery period.
When parents begin to wonder whether their child needs tonsil surgery or only continued medical follow-up, a specialist evaluation becomes the safest and most reassuring step. At Magrabi Hospitals, ENT doctors provide gentle and thorough assessment that helps parents make the right decision without unnecessary anxiety.Learn more about the ENT Department at Magrabi
Yes. In most cases, tonsillitis is caused by viral or bacterial infections that spread through droplets or shared utensils. The illness spreads easily among children in schools and nurseries, so avoiding close contact and encouraging regular handwashing during the infection period are recommended.
Viral tonsillitis usually lasts between 3 and 7 days, while bacterial tonsillitis may take a little longer until symptoms improve after starting antibiotics. The duration varies depending on the child’s age and the severity of the infection. You should see a doctor if fever lasts for more than 48 hours.
Viral tonsillitis is often accompanied by cough, runny nose, and general redness in the throat. Bacterial tonsillitis is more likely when there is high fever, severe pain when swallowing, and obvious pus on the tonsils. The most accurate diagnosis is made by an ENT doctor and may require a throat swab.
You should see a doctor if your child has difficulty breathing or swallowing, high fever that does not improve, pus on the tonsils, marked lethargy, or if tonsillitis keeps recurring. Early intervention helps prevent complications and improves recovery.
Yes. The doctor may recommend tonsil surgery in children if infections are frequent or if they affect breathing, sleep, or daily activity. The decision is based on a careful evaluation of the child’s overall condition, not only the number of infections.
Tonsillitis in children is a common condition that causes understandable concern for parents, but understanding its symptoms and treatment options helps families manage it confidently and effectively. In most cases, the infection is mild and responds well to home care or simple medications, while bacterial cases require medical follow-up to ensure the right treatment is chosen. Medical evaluation remains essential when symptoms persist or infections recur, to ensure the child’s comfort and safety.
This article was edited and medically reviewed by
Dr. Hesham Abdulaziz
Consultant ENT Specialist – Magrabi Hospitals
The information in this article is for health education purposes only and is not a substitute for consultation with a qualified physician. A doctor should be consulted whenever symptoms are severe or persistent.
