PHARYNGITIS AND TONSILLITIS IN CHILDREN

Acute inflammation of the pharynx and tonsils caused by streptococcus, viruses and occasionally diphtheria.

Clinical Features

  • Sore throat
  • Painful swallowing
  • General malaise
  • Fever
  • Body aches
  • Rhinitis.
  • In children vomiting and abdominal pain may be present.
  • Tender cervical or submandibular lymph nodes usually indicates streptococcal infection.
  • Look for membrane in case of diphtheria.

Complications

Streptococcal infections include otitis media, rheumatic fever with or without
carditis.

Investigations

  • Full blood count
  • Throat swab if possible

Management

If conjunctivitis is present, consider viral infection and treat symptomatically at home. If there are yellowish spots or membrane on tonsils or tender lymph nodes treat as streptococcal infection at home with amoxicillin. (If patient is allergic to
penicillin use erythromycin.)

Admit if:

  • Patient deteriorates or goes on to develop peritonsillar or retropharyngeal abscess.
  • There is a grey adherent membrane on tonsils and throat, exclude diphtheria by a throat swab. Barrier nurse a patient who may be toxic. Give crystalline penicillin 25,000 units/kg QDS for 7 days and antitoxin if available.