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Causes of sore throat and acute pharyngitis in children
Medical expert of the article
Last reviewed: 06.07.2025
There are age differences in the etiology of tonsillitis and acute pharyngitis. In the first 4-5 years of life, acute tonsillitis / tonsillopharyngitis and pharyngitis are mainly of viral origin and are most often caused by adenoviruses; in addition, acute tonsillitis / tonsillopharyngitis and acute pharyngitis can be caused by herpes simplex viruses and Coxsackie enteroviruses.
Starting from the age of 5, group A B-hemolytic streptococcus (S. pyogenes) plays a major role in the development of acute tonsillitis, becoming the leading cause of acute tonsillitis/tonsillopharyngitis (up to 75% of cases) at the age of 5-18 years. In addition, acute tonsillitis/tonsillopharyngitis and pharyngitis can be caused by group C and G streptococci, M. pneumoniae, Ch. pneumoniae and Ch. psittaci, and influenza viruses. Staphylococci, Candida fungi, and other microorganisms are much less common pathogens. Anaerobes (Simanovsky-Plaut-Vincent necrotic angina) are detected quite rarely in children.
Tonsillitis/tonsillopharyngitis and pharyngitis, in addition, can be one of the manifestations of such infectious diseases as diphtheria, scarlet fever, tularemia, infectious mononucleosis, typhoid fever, HIV infection (the so-called secondary tonsillitis/tonsillopharyngitis).
[ Pathogenesis of tonsillitis and acute pharyngitis in children
Acute tonsillitis, tonsillopharyngitis and pharyngitis are characterized by a pronounced inflammatory reaction from the mucous membranes and lymphoid tissue of the tonsils and elements of the lymphoid tissue of the back wall of the pharynx. They are often accompanied by the appearance of plaque on the tonsils and the back wall of the pharynx.