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Acute tonsillitis (sore throat) and acute pharyngitis in children
Medical expert of the article
Last reviewed: 12.07.2025
Acute tonsillitis (angina), tonsillopharyngitis and acute pharyngitis in children are characterized by inflammation of one or more components of the lymphoid pharyngeal ring. Acute tonsillitis (angina) is typically characterized by acute inflammation of the lymphoid tissue, mainly the palatine tonsils. Tonsillopharyngitis is characterized by a combination of inflammation in the lymphoid pharyngeal ring and the mucous membrane of the pharynx, and acute pharyngitis is characterized by acute inflammation of the mucous membrane and lymphoid elements of the posterior pharyngeal wall. Tonsillopharyngitis is more often observed in children.
ICD-10 code
- J02 Acute pharyngitis.
- J02.0 Streptococcal pharyngitis.
- J02.8 Acute pharyngitis due to other specified organisms. J03 Acute tonsillitis.
- J03.0 Streptococcal tonsillitis.
- J03.8 Acute tonsillitis due to other specified organisms.
- J03.9 Acute tonsillitis, unspecified.
Epidemiology of tonsillitis and acute pharyngitis in children
Acute tonsillitis, tonsillopharyngitis and acute pharyngitis develop in children mainly after 1.5 years of age, which is due to the development of lymphoid tissue of the pharyngeal ring by this age. In the structure of acute respiratory infections, they make up at least 5-15% of all acute respiratory diseases of the upper respiratory tract.
[ Causes of tonsillitis and acute pharyngitis in children
There are age differences in the etiology of the disease. In the first 4-5 years of life, acute tonsillitis/tonsillopharyngitis and pharyngitis are mainly of a viral nature and are most often caused by adenoviruses; in addition, herpes simplex viruses and Coxsackie enteroviruses can also cause acute tonsillitis/tonsillopharyngitis and acute pharyngitis. Starting from the age of 5, group A B-hemolytic streptococcus (S. pyogenes) becomes of great importance in the occurrence of acute tonsillitis, becoming the leading cause of acute tonsillitis/tonsillopharyngitis (up to 75% of cases) at the age of 5-18 years. Along with this, acute tonsillitis/tonsillopharyngitis and pharyngitis can be caused by group C and G streptococci, M. pneumoniae, Ch. pneumoniae and Ch. psittaci, and influenza viruses.
Symptoms of tonsillitis and acute pharyngitis in children
Acute tonsillitis/tonsillopharyngitis and acute pharyngitis are characterized by an acute onset, usually accompanied by a rise in body temperature and deterioration of the condition, the appearance of a sore throat, refusal of small children to eat, malaise, lethargy, and other signs of intoxication. During examination, redness and swelling of the tonsils and mucous membrane of the back wall of the pharynx, its "granularity" and infiltration, the appearance of purulent exudation and plaque mainly on the tonsils, enlargement and soreness of the regional anterior cervical lymph nodes are detected.
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Classification of tonsillitis and acute pharyngitis in children
It is possible to distinguish primary tonsillitis/tonsillopharyngitis and pharyngitis and secondary ones, which develop with infectious diseases such as diphtheria, scarlet fever, tularemia, infectious mononucleosis, typhoid fever, human immunodeficiency virus (HIV). In addition, a mild form of acute tonsillitis, tonsillopharyngitis and acute pharyngitis and a severe, uncomplicated and complicated form are distinguished.
Diagnosis of tonsillitis and acute pharyngitis in children
Diagnosis is based on a visual assessment of clinical manifestations, including a mandatory examination by an otolaryngologist.
In severe cases of acute tonsillitis/tonsillopharyngitis and acute pharyngitis and in cases of hospitalization, a peripheral blood test is performed, which in uncomplicated cases reveals leukocytosis, neutrophilia and a shift in the formula to the left in the case of streptococcal etiology of the process and normal leukocytosis or a tendency to leukopenia and lymphocytosis in the case of viral etiology of the disease.
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Treatment of tonsillitis and acute pharyngitis in children
Treatment varies depending on the etiology of acute tonsillitis and acute pharyngitis. Antibiotics are indicated for streptococcal tonsillopharyngitis, they are not indicated for viral tonsillopharyngitis, and antibiotics are indicated for mycoplasma and chlamydial tonsillitis only in cases where the process is not limited to tonsillitis or pharyngitis, but descends into the bronchi and lungs.
The patient is prescribed bed rest in the acute period of the disease for an average of 5-7 days. The diet is normal. Gargling with 1-2% Lugol's solution is prescribed. 1-2% hexetidine solution (hexoral) and other warm drinks (milk with Borjomi, milk with soda - 1/2 teaspoon of soda per 1 glass of milk, milk with boiled figs, etc.).
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