Tonsillitis not responding to antibiotics (child)

[Tonsiltrouble]

Just lying awake next to my 5 year old wondering how long I wait before seeking further medical advice and what route.

DS developed tonsillitis on Wednesday and was prescribed Azithromycin as he has a potential issue with amoxicillin. He spent 2 days getting worse on that antibiotic. Was reviewed by GP Friday and switched to cefalexin. He’s now at the point where I would expect to see some improvement but he still has a raging temperature and rigors (fourth night in a row he’s been like this).

So my options are:

1. Wait until Monday and make contact with our GP (might be ok if he doesn’t get any worse in that time)
2. Seek out of hours GP advice (likely to be a waste of time as swab results pending and not clear what else can be done in primary rare)
3. Go to a&e (almost certainly the correct route if he gets worse, unsure if it’s ‘just’ a failure to get better but the only place with alternate treatment options)

I’m usually pretty good at decisions and advice, but am feeling a little overwhelmed by the fact that he just doesn’t seem to be getting noticeably better.

I don’t think at the moment I’m going to do anything in the middle of the night. But I really need him to get better now. It’s heartbreaking that he’s so poorly, when the meds wear off he’s shaking and sobbing.

@Tonsiltrouble Glad he's been seen and they are doing loads of tests. My mum took me to OOH a few times and was always sent to a&e so if anything going straight to a&e and probably just saved you both some time and got him seen and fingers crossed feeling back to his normal self a bit quicker 😊

@Tonsiltrouble

Thanks Lowly. We have been seen by a very lovely ED consultant. He agrees that no improvement by now is unusual, and so we are waiting on a bunch of tests, glandular fever being one of them! At no point has anyone made me feel like I’m wasting time, and whilst ooh might have been appropriate at the start of an illness, if you’re into the realms of running tests thats an a&e thing

Always always trust your gut with these things. Hope he's on the mend soon x

I just had a bout of viral tonsillitis, which was especially galling considering my tonsils were removed in 1994. My GP says that's more common than you'd think and a large number of cases are viral so antibiotics won't work.

I'm glad you've been seen though, hopefully there is something they can give him so he feels better soon.

It’s very hard to tell isn’t it. Could totally be viral, but if it’s not (and the putrid breath, poorly controlled fever and rigors suggest bacterial) and it’s getting worse on antibiotics then the outcome of that can be really scary. As it is, they don’t always take bloods in a&e for children, so hopefully they are looking ok and we can just go home and wait for him to get better. I’m bloody tired though

Even with viral I had terrible breath and a fever - my fitbit said my heart rate didn't dip below 106bpm for a full 24 hours when it was at its worst. DH came in to see me while I was shivering in bed and said, "you look like shit". So kind of him to notice

A&E is the least relaxing place ever so I hope you can both get home and rest up soon. And fingers crossed it is bacterial because at least then he'll get some relief soon.

Thanks 😊 we are actually incredibly lucky to have what must be one of the best children’s ED in the country or even the world. A&E itself was busy but is individual cubicles so once in there is not too bad. But we are round the corner in short stay waiting for results. I have a comfy chair, child is tucked up in bed (another sign he’s unwell, he’s barely moved). It could be so much worse.

any update OP ?

Thanks for asking - we came home about 3ish. Blood picture is confusing. CRP elevated, but not enough to suggest raging bacterial infection, neutrophils are elevated but leukocytes less so. Doctor thinks it’s not a quinsy at the moment, but might become one. Glandular fever also still very much in the mix, awaiting results on that still.

Bottom line is that he still has enormous, pus filled tonsils, he’s still got fever and rigors and he’s extremely clingy.

Doctors were great, just not obvious right now what the issue is.

This must be so worrying for you. I'm sure you know to keep offering fluids and go back to A&E if you think you need to. Really hoping he improves quickly

I’m just really exhausted. And I have a headache. And a really busy week at work. And I’m really crestfallen that I will need to cancel the first face to face thing (client side) I’ve done since before the pandemic. Obviously I’m very happy to sit and hold my unwell child but I was so looking forward to that. And a small part of me is wondering if he will be better for half term. First world problems and all.

You did the right thing, hope he feels better soon!

Thank you 😊 he’s still 39.5 so I will be chasing those outstanding test results with the GP this morning. But he’s gearing up for a whole week off school (and a whole week without sleep for me).

Hopefully things will start to turn around today for him.

Is your half term this week or next week? If it's next weeek then he'll have another whole week to recover.

Hope he's a bit better today and you get some idea of what's going on.

No advice, but heaps of sympathy - one of my kids is prone to tonsilitis and we had a few of those A&E trips when he was younger. It's a nasty illness. In my (regrettably considerable) experience of it, once you've got the right antibiotic the good thing about tonsilitis is it normally improves quickly - really hope that's the case for you here or they work out what else is going on soon.

Thanks. He does seem a bit better today, though he still has a fever. He’s more playful until the nurofen wears out, then he’s a bit flat. Half term is next week thankfully.

I hope he's feeling better now!

I'm in the almost exact same situation right now with my daughter. Can I ask how it's turned out for you?