A sore throat is extremely common in children, teenagers and young adults and is often associated with a high temperature. Tonsils are small glands that sit either side of the throat and are sometimes affected (this is called tonsillitis).

Symptoms of tonsillitis

  • Sore throat and pain on swallowing
  • Fever can be present
  • Swollen, painful glands in the neck
  • Tonsils appear red with pus

These symptoms usually improve within 4 to 7 days.


Most cases of sore throat in young children (under 5 years of age) are caused by viral infections; your child may also have a runny nose, cough or earache. Tonsillitis is sometimes caused by a bacterial infection, usually due to a group of bacteria called a streptococcus (strep throat).

When should you worry?

If your child has any of the following:

  • Is going blue around the lips
  • Becomes pale, mottled and feels abnormally cold to touch
  • Severe breathing difficulty - too breathless to talk / eat or drink
  • Has a fit/seizure
  • Is unable to swallow their own saliva
  • Becomes extremely agitated (crying inconsolably despite distraction), confused or very lethargic (difficult to wake)
  • Develops a rash that does not disappear with pressure (the 'Glass Test')
  • Is under 3 months of age with a temperature of 38°C / 100.4°F or above (unless fever in the 48hours following vaccinations and no other red or amber features)

You need urgent help. Go to the nearest Hospital Emergency (A&E) Department or phone 999.

If your child has any of the following:

  • Is having difficulty opening their mouth
  • Is having breathing problems, such as rapid breathing, shortness of breath or laboured breathing (drawing in of muscles below the lower ribs when they breathe in)
  • Seems dehydrated (sunken eyes, drowsy or no urine passed for 12 hours)
  • Is becoming drowsy (excessively sleepy) or irritable (unable to settle them with toys, TV, food or picking up) - especially if they remain drowsy or irritable despite their fever coming down
  • Has extreme shivering or complains of muscle pain
  • Is 3-6 months of age with a temperature of 39°C / 102.2°F or above (but fever is common in babies up to two days after they receive vaccinations)
  • Continues to have a fever of 38.0°C or above for more than 5 days
  • Is getting worse or if you are worried.

You need to contact a doctor or nurse today. Please ring your GP surgery or contact NHS 111 (dial 111, or for children aged 5 years and above visit 111.nhs.uk10) 

If none of the above features are present.


Continue providing your child’s care at home. If you are still concerned about your child, contact NHS 111 (dial 111, or for children aged 5 years and above visit 111.nhs.uk)

Most children with tonsillitis/sore throat do not require treatment with antibiotics. Antibiotics rarely speed up recovery and often cause side effects such as rash and diarrhea. They will also promote the development of antibiotic resistant bacteria in your child.

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