To ask if A&E is overreacting.

I owldnt blame you for going to an and e, I also wouldn’t blame you for not. It sounds one of those borderline ones at mo. Generally for scarlet fever it’s phenoxymethal penicillin for 10 days. Antibiotics should be having an effect after the second full day. Not sure if this is true or not but I was told once not to mix antibiotics with anything- and it must be consumed in one shot- not drink over a period of time. Tricky I know with a little one but a bribery of chocolate after the syringe or something?

Pen V does cover strep (/Scarlett fever); she should have 10 days.

If she's drinking lots that's very reassuring, you could see how she's doing overnight/tomorrow. Children with quincy/abscess will typically sort of sit, looking v miserable, letting the saliva run from their mouth because they are so uncomfortable. Obviously, they do progress gradually towards that point from having a "normal" tonsillitis, so it's a judgement call.

Nevertheless don't worry about what anyone will think if you do decide to take her to A&E. Working in AE and seeing plenty of relatively well children with tonsillitis - it's no problem and happy to reassure. Sensible doctors understand AE is the last place you want to drag a 5 year old at bedtime and that you only want what's best for your daughter.

A good basic check is does she perk up, or constantly lethargic.

You’d expect cycles with medication peaks and troughs. That molar looks sore - teething stuff is all compatible with antibiotics. As is gargling salt which will almost certainly help keep that a bit calmer.

Perking up for chocolate and biscuits is a good indicator of a childhood lurgy rather than anything sinister.

Last time I had tonsillitis (late last year) I could barely swallow let alone eat. I don't think I ate for 6 days in total, just managed protein shakes with lots of ice in. Can you try something like paediatric shakes for her? They taste like milk shakes if you blend with ice. It's a really nasty illness, leaves your whole body feeling horrific and I'd give her a good 48 hours on the antibiotics before worrying.

that look like scarlet fever, my 10 year old had it just before christmas. She was prescribed 10day course of antibiotic, but it wasn't penicillin, unfortunately dont remember the name

So strep throat / bacterial tonsillitis and scarlet fever are treated by the same antibiotic... at least they were for my kids. Pen V x4 a day for 10 days. If she comes out in a fine, pale pink sandpapery rash, that's classic scarlet fever. In which case take her back to the docs. Disclaimer: I'm not medical.

You know your child so I am not going to tell you not to go to A&E. However she does just sound... ill. If she's drinking and only lethargic when her temp spikes, that's a positive sign, I think. Do you have any support with her? A partner / family?

She is drooling and has trismus (inability to open mouth normally), in the context of tonsillitis especially with fever ongoing/recurring at 48 hours on Abx - these are red flags and yes I would take her to A&E. Don't be alarmed but I think that is the right course of action as I would want to rule out a tonsillar abscess/quincy. They are treatable but do need to be seen in hospital. Hopefully as you suspect it is just the molar contributing but I don't think this is an overreaction.

The cookies are good hard enough to scrape some crud off her throat

I've had an ulerated tonsil I couldn't eat anything at all

Honestly she probably has a sore jaw which is why she won't open her mouth I'm assuming she won't pass the chin to chest check either? Ds used to fail that on the meningitis question from 111 so they woukd say A&E NOW! They sent an ambulance once he literally had tonsillitis we knew he did we just wanted an out of hours appointment but they made us wait 6 ish hours for an ambulance instead

The joys

If she has tonsillitis, she has antibiotics, all her symptoms are consistent with it, and sounds like her natural body defences fighting the infection.

Make sure she is taking in fluids, don't stress too much about not eating, she will have reduced appetite and a sore throat.

Keep her on paracetamol too, take the edge off the pain.

Tonsillitis can be excruciating, last time I had it, as a full grown adult I was sobbing and was in bed for days, it was awful.

That said, she is your child, you know her better than anyone, if you are concerned, 111, walk in or a&e.

Don’t sweat what food she’s prepared to eat right now. Give her what she wants and offer her other options too, but no pressure if she doesn’t want them.

The separate children’s A&E generally isn’t as busy, not that I’m saying that this is necessarily an A&E trip, but there often aren’t the same patterns as in adult, e.g. it might be really quiet overnight.

She’s on the correct antibiotic for potential strep throat (is it a 10 day course?)

Has she had penicillin before as she could be allergic? My son had antibiotics for the first time (aged 10) this year and after a day or 2 came out in a rash which was diagnosed as Scarlet Fever, for which he got more antibiotics but he started vomitting after each dose and eventually I worked out he had a penicillin allergy. They don't test for it but as soon as he came off then he was fine.

@CoconutSky would she eat some yoghurt??? It will be cool for her mouth x