Enlarged tonsils in a child may indicate that the body is fighting some kind of infectious carrier, or some other pathologies. With this symptom, it is necessary to treat the underlying pathology in the body.
Author:
- Oganesyan Tigran Sergeevich
ENT pathology expert
4.10 (Votes: 10)
Tonsils (tonsils) are a collection of lymphoepithelial tissue, which is the point of contact of the immune system with the external environment. Thanks to this, the body produces protective immunoglobulin proteins in response to bacteria, viruses, fungi and other foreign microorganisms. Thus, the formation and maturation of immunity occurs. Located at the border of the respiratory and digestive tracts, the tonsils promptly intercept viruses and bacteria that enter the body with inhaled air, water and food.
Enlarged tonsils in a child are not a separate disease. They say:
- that the body is fighting some kind of infectious carrier;
- about genetically determined proliferation of lymphoepithelial tissue without an infectious agent;
- about possible blood diseases (oncohematological diseases), autoimmune diseases and diseases of the endocrine system.
The problem is that tonsil hypertrophy progresses quickly, and it is important not to miss the moment when the painful condition begins to cause severe discomfort to the child, but to treat the underlying pathology in a timely manner. Only an experienced doctor, whose specialization is children's ENT diseases, can correctly determine the true factor in the appearance of the symptom and choose competent therapy to eliminate it.
When should you see a doctor?
Even slightly enlarged tonsils in a child are a signal to contact a pediatric otolaryngologist. However, mild hypertrophy of the glands often does not manifest itself in any way, so it cannot be noticed visually. A visit to the doctor is required if the child, in addition to enlarged tonsils, has:
- classic signs of a cold: pain when swallowing, redness of the throat, cough, nasal congestion, fever, uncharacteristic weakness, headache;
- white plaque on the tonsils;
- swollen lymph nodes;
- pustules, ulcers in the larynx;
- swelling of the neck.
Complications of tonsillitis
With proper treatment, recovery occurs in 7-10 days. If medications are ineffective, life-threatening complications may develop:
- paratonsillitis - acute inflammation of the tissues near the tonsils;
- peritonsillar abscess - the formation of a cavity with pus inside the same area;
When the process spreads into deeper tissues, phlegmon may develop. All types of complications are observed and treated exclusively in the hospital, with further use of surgical treatment methods .
Causes of enlarged tonsils in children
The increase is caused by the following infectious agents: pneumococci, staphylococci, herpes, streptococci, chlamydia, Haemophilus influenzae, adenovirus, influenza virus. They can be located in the lacunae of the tonsils without manifesting themselves in any way (for example, remain after treatment for a disease), but at a favorable moment they begin to actively multiply and cause an enlargement of the organ. Such triggers can be:
- decreased immunity;
- allergies;
- bad ecology;
- hormonal disorders;
- severe hypothermia;
- lack of vitamins;
- infections.
Forms and classification of tonsillitis in children5
It should be noted that there is fundamentally no difference between adult and child forms.
The disease is divided according to:
- By shape
- By pathogen
- According to the form of the lesion
| CLASSIFICATION | A COMMENT | ||
| classification: | According to the form they are distinguished: | a comment: | - acute tonsillitis or sore throat - chronic tonsillitis |
| classification: | According to the causative agent, tonsillitis can be: | a comment: | Bacterial: - beta-hemolytic streptococcus A and other groups - staphylococcus - pneumococcus - moxarella Viral: — Influenza and parainfluenza virus — adenovirus — coronavirus — Epstein-Barr virus — enteroviruses — Coxsackie virus — herpes virus types I and II Fungal: mold fungus Candida albicans. As noted above, tonsillitis may be a manifestation of another disease: — measles — rubella — scarlet fever — mononucleosis |
| classification: | According to the form of the lesion: | a comment: | - catarrhal - follicular - lacunar - phlegmonous - ulcerative-necrotic - mixed form |
Most often, children suffer from the viral form of tonsillitis.6
The degree of enlargement of the tonsils in a child
There are 4 stages of hypertrophy of the glands:
- At the first stage, the inflamed tissue of the tonsils covers no more than 30% of the lumen between the pharynx and the sky. In this state, it causes almost no discomfort, so it is difficult to detect at this stage.
- At the second stage, hypertrophied tissue covers half of the lumen. The child begins to have difficulty swallowing and breathing freely, and a sensation of a foreign body in the throat.
- At the third stage, there is severe difficulty in breathing and swallowing.
- On the fourth, the pharynx is almost completely blocked by inflamed tonsil tissue. It is difficult to bring the condition to this stage, since already at the third stage the child’s well-being requires immediate medical attention.
Adenoids treated or removed
The most common pathology in children is enlargement of the nasopharyngeal tonsil (adenoid vegetations, adenoids). According to various authors, the presence of adenoids is noted in children under 14 years of age from 5 to 45% of cases .
adenoids
Adenoids are located in the vault of the nasopharynx, where the nasal cavity ends, serving as a natural filter that prevents viral and bacterial agents from entering the lower parts of the respiratory system - the trachea and bronchi. In children, during the inflammatory process in the adenoids (local fight against viral or microbial agents in the tissue of the nasopharyngeal tonsil), difficulty in nasal breathing may be observed due to the fact that the tissue closes the lumen of the nasal cavity at the back, thereby interfering with the normal passage of air, the presence of mucous discharge in the anterior parts of the nasal cavity, snoring. Children experience a “choking” type cough due to secretions getting from the nasopharynx onto the vocal cords.
Cough is not always associated with adenoiditis (inflammation of the adenoids). Often, a cough is associated with one or another problem in the lower parts of the respiratory system (tracheitis, bronchitis, pneumonia, childhood infections). To exclude this pathology, the child must be consulted with a pediatrician, who will perform auscultation (listen to organ sounds), giving a conclusion about the presence or absence of pathology.
Due to the specific location of the adenoids, it is impossible to apply ointment, apply sprays, or use rinses; because of this, adenoids take a relatively long time to be treated.
How is inflammation treated?
The tactics for treating enlarged tonsils in a child consists of treating the underlying disease that caused this symptom (taking antibiotics, antiviral or antifungal drugs), and influencing them directly to regenerate the affected tissues. The latter includes:
- washing the tonsils from pathogenic microorganisms and mucus with antiseptic solutions;
- reducing swelling - taking antihistamines and ultraviolet irradiation;
- UHF therapy, which improves blood microcirculation;
- exposure to ultrasound to free the lacunae of the tonsils from pus, which can accumulate in them;
- laser exposure to destroy infection and its pathogens.
Treatment of hypertrophy of the palatine tonsils
To delete or not to delete - that is the question. The answer to this depends on how much the overgrown tissue burdens the child’s life. If the tonsils are too large, they are trimmed down to normal size, making room for air and food. This operation is called partial tonsillotomy. The remaining tissue is quickly restored and fully copes with its tasks. But if the reasons that prompted it to increase so much remain in force, there is a risk of the situation repeating itself.
How to treat hypertrophy of the palatine tonsils in a way that is not so radical? Reduce the load on the lymphoid tissue of the pharynx. To do this, firstly, treat diseases of both the upper respiratory tract and other organs. Secondly, not only “fight the enemy,” but also help the body become capable of self-defense. In addition to the immortal healing “triad” - sun, air and water, an individual diet is also suitable. This is not a dietary restriction, but an integrated approach to choosing food products that are healthy for a given child, physical exercise, a hardening system, a daily routine, the psychological atmosphere in the home, etc. After all, the Greek word “diet” originally meant a way of life in general.
Holistic methods of influencing the body - homeopathy, herbal medicine and acupuncture - can provide good help to the child’s body.
Make an appointment
Prevention of tonsillitis
There are individual preventive measures aimed primarily at strengthening the immune system.
A healthy lifestyle and the absence of bad habits such as smoking and drinking alcohol play a key role. Don’t forget about hardening the body, doing physical exercise, regularly spending time in the fresh air, and consuming enough vitamins with food.
In the modern world, special attention is paid to the use of various biologically active additives (BAS) to improve health, including for the prevention of colds and strengthening the immune system.
The composition of such supplements is very diverse and rich, including various vitamins, minerals, nutrients, and substances of plant origin.
They come in the form of tablets, lozenges, dragees, drops, etc. But you shouldn’t count on “magic”; such supplements will not cure all diseases, but they will really help direct the body to work in the right direction and improve the effect of the main treatment. It is also important to choose the right biological supplement, focusing on the body’s needs and its problem. For example, lozenges can help strengthen the immune system.
Tantum® Propolis 13
Propolis is a valuable substance that has been used for medicinal purposes since the times of Hippocrates, Discorides, Avicenna and others, and is used in modern medicine to this day.
Plants from which bees collect and carry resinous substances have bactericidal, anti-inflammatory, immunomodulating, and antiviral properties.14 Find out more
Not being a medicine, Tantum® Propolis can support the patient’s immunity during seasonal ARVI and influenza, reduce pain, irritation and itching in the throat, and also replenish the lack of vitamins in the patient’s body.
In preventing complications, it is very important to consult a doctor on time, follow the prescribed treatment regimen and recommendations, and avoid self-medication.
Types of disease
- Spicy. Most often, the acute form develops after suffering from acute respiratory viral infection, due to reduced immunity. Source: A.D. Vetrova Acute tonsillitis in children: a pediatrician’s point of view // Pediatric pharmacology, 2014, v. 11, no. 2, pp. 61-64
- Chronic. Occurs after relapses if the patient has not fully recovered. Diseases in the mouth, nose, and structural features of the tonsils contribute to the development of chronic tonsillitis. Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6248716/ Raja Kalaiarasi, Kalaivani S Subramanian, Chellappa Vijayakumar and Ramakrishnan Venkataramanan Microbiological Profile of Chronic Tonsillitis in the Pediatric Age Group // Cureus. 2022 Sep; 10(9): e3343
The meaning of the palatine tonsils
Before you think about performing an operation on an adult or child, you need to understand that nature does not create anything for nothing. And our tonsils are no exception. The tonsils are by no means a useless organ, the removal of which will pass without leaving a trace.
The palatine tonsils, despite their small size, are a powerful barrier that protects our body from viruses and bacteria. They consist of lymphoid tissue. When an infection gets on the surface of the tonsils, they begin to intensively produce leukocytes that kill pathogenic organisms. Then the defeated infection, along with the dead leukocytes, is excreted. This is how a healthy amygdala works.
External causes and weakened immunity reduce the protective properties of the tonsils. The tonsils of an adult or child stop coping; pathogenic microflora settles in their lacunae, maintaining constant inflammation in them. This is how chronic tonsillitis develops.
Pus plugs that appear on the surface of the tonsils are nothing more than a compressed infection.
This condition must be treated without fail. And surgery is only the most extreme option.
Surgery to remove tonsils
The importance of the tonsils cannot be underestimated. We found this out at the very beginning of the article. The main goal of any therapy is to try to reduce the tonsils without surgery and preserve them as an organ of the immune system. Many adult patients mistakenly believe that they will have less pain after surgery. It is a myth! Yes, the tonsils will stop bothering you. But now the infection from the outside will enter the pharynx and further into the respiratory tract without encountering any obstacle, which will not have the best effect on the incidence of respiratory tract diseases.
The operation to remove the tonsils is called tonsillectomy.
Certain indications are required for the operation. The patient's fatigue due to frequent exacerbations and unpleasant symptoms is not such an indication.
Surgical intervention is prescribed in the following cases:
- recurrence of sore throats more than four times throughout the year;
- a peritonsillar abscess that has occurred;
- poor performance of rheumatic tests;
- complications on other organs and systems of the patient.
Before deciding to undergo surgery, it is necessary to try to treat a child or adult patient conservatively, that is, to reduce the tonsils without surgery.
Diagnostic methods
During the consultation, the doctor will examine the patient’s throat and palpate the lymph nodes. The examination should be carried out by a pediatrician and pediatric ENT specialist. In case of decompensation of the chronic form, the child requires consultation with a pediatric cardiologist, rheumatologist, nephrologist, because tonsillitis can cause concomitant diseases. To rule out pockets of infection in the oral cavity, the child should be examined by a dentist. Laboratory and instrumental studies are also prescribed:
- blood and urine tests;
- pharyngoscopy;
- blood test to determine C-reactive protein;
- definition of ASL-O;
- bacterial culture from the pharynx for flora.
If there are difficulties in making a diagnosis, additional studies may be required - ECG, x-ray of the sinuses, etc.
