Recurrent tonsilitis (age 6)

[mulberrybag5]

Hi all

Does anyone have any experience of this please?

DS is 6. He’s had tonsilitis once or twice a year up to this year. This year he’s had it 5 times, 4 of those since September.

September 2022
#1 - treated with amoxicillin
3 weeks later #2 treated with penicillin

December 2022
#3 treated with an anti biotic beginning with C which I need to google!
2 weeks later (this week) #4 when GP says he’ll prescribe anti biotics but try not to use them unless it’s not shifting (penicillin)

The GP we saw earlier this month for #3 said he could feel 3 glands on the right side that were former than he’d expect and he offered to either wait 2 weeks to see if they come down or go for a blood test. I said we may as well have a blood test booked as the waiting list would only get longer.

a few days later, glands were down and my two friends who are both doctors couldn’t feel anything.

This week, symptoms back and glands up on both side. I saw a different GP this time who was quite abrupt and dismissive - said he could see a glandular fever screen had been requested on the bloods, no point referring to a private ENT, no one would ever consider taking the tonsils out etc.

He is completely fine in himself. Eating, drinking normally, he’s been at school, no tiredness, nothing out of the ordinary except his normal tonsilitis symptoms of throat, head and tummy ache. Oh and he has a cough this week!

Is this number of episodes something I should be following up? What are the blood tests like to show? (It’s not until 19th January). What’s everyone’s experiences of recurrent tonsilitis in children?

just looking for a bit of support, thank you for reading xxx

My son had it a few times back when he was 4/5.
His problem mainly was enlarged tonsils (mainly without infection!) causing sleep apnea, and then in turn of that, night terrors! He also experienced glands being swollen aswell as the tonsils but no infection - so presumably viral.
I was told with tonsillitis - more than 7 episodes/infections in a year then they'll look at removing them. Fortunately (because he wasn't suffering THAT bad with infections) we had the sleep apnea being caused which then went in our favour. So he was then referred to ENT, had a sleep study and then was told he can have them out - once it was over we were told they were massive for a child of his age. It's the best thing we ever did.
Push for a referral if you can. It's not healthy to be on antibiotics so young and that much either! Especially if it carries on. Make sure every time it's logged with the GP and just keep standing your ground with it. Unfortunately i have no experience with blood tests as he never had none x

My DS has had recurrent tonsillitis. GP told me once tonsils are enlarged they can become a breading ground for bacteria. I had awful recurrent tonsillitis too and had them whipped out at 16.

I had a test for glandular fever at the time which was negative. However years later I had a full blood screen which showed I’d had a previous infection. Apparently it’s really common to get a false negative so might be worth retesting later on if it doesn’t resolve.

Thank you both. I’m just in such a state of worry about it. Started anti biotics on Friday but tonight (Sunday) tonsils still looking enlarged.

How long is he on antibiotics for each time?

When DC2 had tonsillitis again 2.5 weeks after the last bought I was told it was because was the previous infection hadn't completely cleared. When my older two got tonsillitis 5 or 6 years ago, they were prescribed 10 day courses of antibiotics to stop it reoccurring. Guidance seems to have changed since, DC3 only gets 5 days worth now. If your DS is only being prescribed 5 days it might be worth reminding them of his history of repeat bouts and asking if it's worth considering a longer course?

Both bout 1 and 3 were 7 day courses. I don’t think anything clears it off except 10 days of penicillin and I do wonder if amoxicillin and the one beginning with c just doesn’t clear it off?

I dosed DS (6) up with pain meds for 3 days and didn't take him for antibiotics. GP said at the previous bout, try without next time. I think I took this too literally as DS was very sick for those few days. However he went from episodes every 6 weeks to never having tonsillitis again. Wouldn't recommend it though.

DSis, little girl eventually had her tonsils out (rare they do this) and still had infected throat episodes, though not as many. She was like DS though with very frequent bouts and needing antibiotics all the time

I did the same for weds, thursday and Friday but then started anti biotics. Maybe I should have tried another day or so!

Bumping for similar thread

I would say he doesn’t meet the criteria for tonsillectomy yet, though tonsillitis can be hard to get rid of, and if this is the pattern you may well be looking at tonsil removal.

Criteria as follows:
<i>The Commissioner will provide funding approval for a referral to secondary care providers for consideration, and subsequent provision of, a tonsillectomy if the following criteria are met:

Sore throats are due to acute tonsillitis and symptoms have been occurring for at least a year.

AND
the frequency of episodes of acute tonsillitis is confirmed by the patients’ GP as follows:
• Seven or more well documented, clinically significant, adequately treated sore throats in the preceding year
OR
• Five or more such episodes in each of the preceding two years
OR
• Three or more such episodes in each of the preceding three years.

AND
The episodes of sore throat are disabling and cause significant functional impairment.
Significant functional impairment is defined as:
• Symptoms prevent the patient fulfilling routine work or educational responsibilities
• Symptoms prevent the patient carrying out routine domestic or carer activities

Evidence to support the request including dates of episodes of tonsillitis must be recorded in the patient’s clinical notes.</i>

That said, both of my DC have had their tonsils removed (one recently), and it is a brutal operation with a miserable recovery. It is something you have to be very sure is the right course of action.

My other child had his removed very young but it was carried out privately using the intrapcapsular method with no recovery time afterwards. However, if he can avoid having them out then I’m definitely keen to try!

DD is 3 and had a year of recurrant tonsillitis, they took hers out in April because they'd given her antibiotics pretty much every time and it cleared it for around 2 weeks then it was back again. I didn't want to have to get them out but she was always so ill, we were both miserable and sleep deprived and now she's a happy 3 year old who only has issues with her reflux not tonsillitis or ear infections (got grommets at the same time)

My younger ds got grommits at the same time too!

did they test for ebv first?

So my dd5 has HUGE tonsils all of the time. When I spoke the GP they said the criteria for referral was 5 episodes of tonsillitis per year or sleep problems with gutteral snoring and waking a lot at night.

I have a friend who is a GP and had hers out as an adult, she said to take my daughter every time there’s a problem as they won’t count the times you ride it out at home…she also said it was awful having hers out as an adult and if it was her child she’d want it done asap...

i have two friends who suffer terribly in their 30s who say they wish they could have had them out as a child!

I was so poorly with tonsillitis as a child, my mum ended up sending me private to have them out as the NHS were taking their time..... no change then!

So that’s the big issue with tonsillectomy for infection - the intracapsular option doesn’t remove all tonsil tissue and so whilst relatively rare, reoccurrence of tonsillitis is more possible. It’s also possible for the tonsils to regrow from the remaining tissue.

Both of our children have had full open capsule tonsillectomy which is a much more complicated recovery. My 6yo had terrible pain and when his meds wore off he was just running in little circles crying. It’s of course right that we removed the tonsils, he had had 9 bouts in a 10 month period, but it can be a much more involved process than people realise.

My youngest had the inteacapsular method and hadn’t had any reoccurrence. When he’s unwell now and has a sore throat his temperature isn’t as high and he hasn’t convulsed like he did with tonsilitis (temp 40.9 and unconscious for 20 minutes) so I think that method was right for him. I completely agree the full way is a much more involved process and not straight forward.

I’m glad it’s been an improvement but I guess if your older child is only 6 then your younger child won’t have had enough time post tonsillectomy to know for sure, eg my mum had hers out as a child, but not the whole capsule, and hers have grown back and she now gets tonsillitis again, but that took about 25 years I think