Tonsils are pads of lymphoid tissue in the throat, on each side, and when the child opens his mouth wide, these can be seen as small, rounded projections in the throat.
Tonsillar infection is common in childhood, and this leads to enlargement of the tonsils, which become almost the size of walnuts and may seem to meet in the midline.
This enlargement lasts for many years and begins to go down after the age of 8-10 years. This by itself leads to no problems at all, and nothing needs to be done about it.
If the child gets repeated infection with high fever, pain and redness in the throat, then the management is entirely different.
Tonsillitis means inflammation of the tonsils.
This is also called “strept” throat because the commonest cause of infection is streptococcus. The child has high fever, malaise, headache, and may complain of pain in the throat.
The tonsils look angry and red and there are whitish patches on one or more tonsil, referred to as follicles.
This condition has to be distinguished from diphtheria. A smear examination from the patch will confirm the diagnosis.
The child should be treated adequately (usually 10 days) with penicillin, or a substitute. This is important because if the condition is not treated adequately, the streptococcal infection can lead to rheumatic fever.
Some years ago, any child with enlarged tonsils was subjected to tonsillectomy, i.e., removal of tonsils by operation.
With so many drugs effective against throat infection, it is now no longer necessary to do so.
An episode of tonsillitis can easily be treated with penicillin or a substitute, depending on the preference of your doctor. If a child has repeated episodes of infection, he can be put on long-term penicillin either by mouth or through injections.
This can be continued for several months. Naturally, your doctor will be the best person to decide on the line of management.