To check your child's tonsils, gently place the handle of a spoon, if possible, on his or her tongue and ask the child to say "aaahhh" while you shine a light on the back of the throat. If the tonsils look bright red and swollen, see your pediatrician or family doctor. Do not insist on doing this exam if you or the child is reluctant.
Often tonsillitis due to a virus looks no different than one caused by bacteria. Your pediatrician will examine your child's tonsils and take a throat swab to check for strep throat. The test can be done with results available during the office visit. This is the rapid strep test. If this is negative a culture is done for confirmation which takes 24-48 hours. To check for a tonsillar abscess, the doctor will examine the tonsils and soft palate.
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Since most of the time infection is due to a virus and not a bacteria, antibiotics are not routinely needed. For a bacterial infection such as strep, the doctor will prescribe an antibiotic, usually for 10 days. Be sure to give your child the full course; if unchecked, strep bacteria can cause serious conditions such as an abscess or rheumatic fever (a heart condition). If the infection is due to strep, the contagious period is over after the first 24 hours of using antibiotics.
If the throat culture is negative for bacteria, the infection is probably caused by a virus and requires only treatment for relief of symptoms. To ease pain, the doctor may also recommend acetaminophen (Tylenol) or ibuprofen (Advil). Do not give your child aspirin, which has been linked to Reye's syndrome, a life-threatening condition. Gargling three times a day with warm salt water (1 teaspoon of salt in 8 ounces of warm water) may relieve some of the pain.
If your doctor discovers or suspects an abscess, you may need to be seen by an ear, nose, and throat doctor (called an ENT or otolaryngologist) to be evaluated for possible drainage of pus.