5 Recurrent episodes of Tonsillitis in the last 5 months for an 11 year old boy. What to do?

Question

My 11 year old son has had sore tonsils for the last five months. There are no obvious signs of infection, however his tonsils are sore, enlarged and red. Blood tests have shown that it is not bacterial however he always responds well to antibiotics and begins to feel better 24 hours after he commences antibiotics. After he has finished taking antibiotics he has a few good days then he gradually goes down hill again. Within a week and a half we are back at the doctor, he is put back on antibiotics and after a day he feels better again. The question is do we remove his tonsils if it is viral tonsillitis??? 7 years ago, when he was 4 years old, we took him to an ENT surgeon, the surgeon was keen to remove his tonsils. Now that he is 11 years old and we went back to see the same ENT surgeon, the surgeon has changed his tune and has now become conservative and reluctant to remove them, he stated to us that "If it is viral tonsillitis then there is no point taking out the tonsils at all" It would seem to me ENT surgeons have changed their tunes regarding the removal of tonsils over the years, I wonder why?????? Does anyone have any suggestionsns on what I should do for my son, I'm wondering if his tonsils are making him sicker somehow. His symptomsover the last 5-6 months have been:

- Sore, red and enlarged tonsils,

- some ear pain and pressure,

- Headaches,

- Occassional fever

- Sore sinuses, only when pressure is applied,

- Red, rashy cheeks

- Lethargy,

- Balance problems, he feels like he is going to fall when he is running,

- He has a raised ESR

He responds well to antibiotics in 24 hours even though blood test results don't indicate a bacterial infection. Two blood tests over a period of a month eliminated glandular fever.

I look forward to your suggestions.

Answer 1

A tonsillectomy should be considered when tonsillitis attacks are so frequent or severe that they affect a child's general health or interfere with school, hearing, or breathing. However, some physicians believe tonsillectomies are done more often than necessary, so get a second opinion when there is any doubt.

Specifically, the guidelines for surgery are:

7 or more episodes of tonsillitis in 1 year

5 or more episodes per year over a 2-year period

Enlarged tonsils that interfere with breathing

An abscess in the tonsils

Grossly asymmetric tonsils

Answer 2

They probably should have removed them.

After the next recurring episode, with anti-biotics no doubt;  with the problem cleared, have him gargle with warm salt water at least once a day, twice if okay.  Virtually forever.

If he can eat ginger or drink ginger tea it will help create an atmosphere in which the bacteria are challenged.

I am concerned, because you don't want him to accidentally be given aspirin anywhere, leading to Reye's syndrome, and you don't want him growing up, only to become septic at some point.

Goodness, taking them out would have been so easy.

Well, practice overly-diligent oral hygiene and brushing/flossing too.

Consume less sugar and more fruits and fiber just to boost immunity and overall health.  Vitamins too, if you like.

I am not and never was a homeopath....

Answer 3

I see some great answers above!

Your son is now a teenager and the general changes in his body associated with puberty may have triggered the recent tonsil flare up. My initial reaction was to have them removed but I do understand why the surgeon may be reluctant to remove them at this point, (a) the procedure is much simpler in young children and (b) the bout of tonsillitis may indeed be "temporary".

However, because his symptoms are pretty severe at onset and it does respond to antibiotics, I am concerned that your son does not complete and finish the antibiotic course after he starts feeing better. I by no means want to upset you but are you sure he completes the full  2 week (or what have you) course of antibiotics?  It is very important that he finishes them all and that he does not lower or abandon the dosage when he starts feeling better or anytime thereafter. Also, so as to point out that doctors are not always perfect, maybe a different antibiotic could be used next time to cover a wider spectrum.