How long should tonsils stay swollen?

[lotsofpumpkins]

My dc have had tonsillitis. They start with a fever for a day or two, a minor sore throat, and very swollen tonsils (with a few little white patches, but not severe). My almost-2yo was the first to get sick but I can't get a good look at his tonsils to see if they are swollen or not. He ran a fever for two days and then was fine. My 4yo was next. She came down with the fever and sore throat 12 days ago. After 2 days of fever, she felt fine. Her tonsils look some better; they aren't as red, but they are still swollen. My 7yo and 9yo had fevers 8 days ago. Same thing- fever for a day or two, minor sore throat, but nasty looking tonsils. I just looked at their throats again and they are still swollen, though I'm not seeing the redness and white patches anymore. My 5yo has a fever today. My 10yo hasn't run a fever but has a nasty cold; I'm not sure if it's from the same virus or something else.

 

ANYWAY, we don't think it's strep because their throats have not been very sore, plus the younger dc were sick too, and I know that strep isn't as common in preschoolers. I had strep throat several times as a child and I couldn't even swallow water without considerable pain, and my dc have not had this. It's just minor soreness for a couple of days. So, since I think it's a virus, we haven't taken any of them to the doctor. But I was wondering how long we should expect the tonsils to remain swollen. dd is at 12 days now. I wish I could get a good look at my youngest's throat to see how his look, but he doesn't understand that I want him to open his mouth AND stick his tongue out AND say "ah" all at the same time. :)

 

Thanks for any help you can give me!

[Lolly]

Strep sometimes doesn't even have a sore throat. When my kids were younger, they would just have a tummy ache with strep.

[DianeW88]

Strep does not have to present with a sore throat at all. The fever, if there is one, is generally low. Some kids in the practice where I work only have a stomach ache and headache with mild fever. Some have nasty red, painful throats. Some just have a headache, fever and malaise. Strep can be many different symptoms to many different people.

 

And preschoolers most definitely CAN have strep.

 

There is absolutely no way under the sun to determine whether or not a throat infection is bacterial or viral without a throat culture. If you do not have any other symptoms of an upper respiratory infection, such as nasal stuffiness, drainage, runny nose, coughing, that would clearly indicate a cold, strep is a definite possibility.

 

Strep throat is treated with antibiotics, not because the infection won't clear up without them...it will, in a few days to a week...but because it can lead to rheumatic fever and lifelong heart problems such as arrhythmias, mitral valve stenosis, endocarditis, pericarditis and heart failure. It can also destroy joints and give you arthritis symptoms. Children who contract rheumatic fever following a strep A infection are generally placed on a continuous course of antibiotics for 3-5 years. It will show up anywhere from 2 weeks to a month after a strep throat infection and the symptoms are:

 

fever

heart problems

joint pain and swelling

nosebleeds

skin nodules

rash

chorea (jerky, spastic movements of the feet and hands and weird facial contortions)

 

That is why doctors will give you a prescription to treat strep, often before a throat culture comes back positive, if the doctor strongly suspects strep. Rheumatic fever stinks and can leave you with heart problems for the rest of your life. The minimum difficulty you will have after recovery is that you will need to take antibiotics before every dental procedure you have done for the rest of your life.

 

Strep throat is seriously nothing to mess with. Throat cultures are quick and painless and can prevent lifelong struggles.

[lotsofpumpkins]

Strep does not have to present with a sore throat at all. The fever, if there is one, is generally low. Some kids in the practice where I work only have a stomach ache and headache with mild fever. Some have nasty red, painful throats. Some just have a headache, fever and malaise. Strep can be many different symptoms to many different people.

 

And preschoolers most definitely CAN have strep.

 

There is absolutely no way under the sun to determine whether or not a throat infection is bacterial or viral without a throat culture. If you do not have any other symptoms of an upper respiratory infection, such as nasal stuffiness, drainage, runny nose, coughing, that would clearly indicate a cold, strep is a definite possibility.

 

Strep throat is treated with antibiotics, not because the infection won't clear up without them...it will, in a few days to a week...but because it can lead to rheumatic fever and lifelong heart problems such as arrhythmias, mitral valve stenosis, endocarditis, pericarditis and heart failure. It can also destroy joints and give you arthritis symptoms. Children who contract rheumatic fever following a strep A infection are generally placed on a continuous course of antibiotics for 3-5 years. It will show up anywhere from 2 weeks to a month after a strep throat infection and the symptoms are:

 

fever

heart problems

joint pain and swelling

nosebleeds

skin nodules

rash

chorea (jerky, spastic movements of the feet and hands and weird facial contortions)

 

That is why doctors will give you a prescription to treat strep, often before a throat culture comes back positive, if the doctor strongly suspects strep. Rheumatic fever stinks and can leave you with heart problems for the rest of your life. The minimum difficulty you will have after recovery is that you will need to take antibiotics before every dental procedure you have done for the rest of your life.

 

Strep throat is seriously nothing to mess with. Throat cultures are quick and painless and can prevent lifelong struggles.

 

Thanks for the info! My 5yo definitely has cold-like symptoms in addition to the fever and sore throat. He was congested and coughing even before the fever started.

 

But now I'm thinking maybe I should at least take one of the dc in for a throat culture. My 4yo is due for a well check anyway; if she was sick almost 2 weeks ago would a culture still show anything? Or would it be better to take the dc who is currently the sickest? BTW, the fevers were around 102 in the dc, except for one ds who got up to 104. I don't consider their fevers to be low at all, which is another reason I suspect virus.

[lotsofpumpkins]

Ok, here's another question. You said that some children only have a headache, stomachache, and mild fever with strep. How would a parent even know to take their child to the doctor to check for strep? My dc have to be pretty sick for me to take them to the doctor, because I know that most illnesses they get are viral and they run their course. Back in Feb we ended up taking 5 of them to the doctor because they were running 104 fevers for a few days. Turns out they had ear infections without much ear pain. But this time the children only ran fevers for 1-2 days and then felt fine. And to be honest, this is the first time we've ever really looked at their tonsils ourselves, only because my Mom happened to look at my 4yo dd's throat and said her tonsils were swollen. Dh and I had never looked at their tonsils very closely when they've had sore throats and fevers before. I've checked their throats for redness before, but I honestly don't ever remember seeing their tonsils swollen like this; I guess I would have noticed if they were.

 

Oh, and I realize that throat swabs are painless and easy (except for the gagging). However, the doctor bills are not so painless. We have a high deductible so if we opt to take just one of the dc to the doctor to check their throat, it's $70 for the visit plus the cost of the test. Multiply that by several children and it's very pricey. Our doctor will not do tests or write prescriptions for other children in the family unless they also pull their charts and charge for a visit. Yes, we will pay it if we have to (as we did back in Feb) but we don't just run to the doctor for what appears to be a childhood virus (dh and I have not gotten sick).

[DianeW88]

Take the sickest child if you take anyone.

 

Strep can have a higher fever as well. It presents all over the board. My only point was that a child didn't HAVE to have a high fever to still have strep.

 

Certain ethnic groups are more prone to rheumatic fever than others. Those of European ancestry are more susceptible than Hispanics or African Americans. Here in Utah, we have a high rate of rheumatic fever following strep infections, so doctors are fairly aggressive about treating it. In other places, that may not be the protocol.

 

And yes, you might not necessarily take a child in for strep if their symptoms are mild. Fortunately, rheumatic fever is somewhat rare, so chances are your child wouldn't have that complication. However, the rule of thumb is that any child who has a fever for more than 72 hours, without it trending downward, needs to be seen to make sure it isn't a bacterial infection. Parents who don't follow that guideline may have kids that end up with complications from illnesses.

[lotsofpumpkins]

Take the sickest child if you take anyone.

 

Strep can have a higher fever as well. It presents all over the board. My only point was that a child didn't HAVE to have a high fever to still have strep.

 

Certain ethnic groups are more prone to rheumatic fever than others. Those of European ancestry are more susceptible than Hispanics or African Americans. Here in Utah, we have a high rate of rheumatic fever following strep infections, so doctors are fairly aggressive about treating it. In other places, that may not be the protocol.

 

And yes, you might not necessarily take a child in for strep if their symptoms are mild. Fortunately, rheumatic fever is somewhat rare, so chances are your child wouldn't have that complication. However, the rule of thumb is that any child who has a fever for more than 72 hours, without it trending downward, needs to be seen to make sure it isn't a bacterial infection. Parents who don't follow that guideline may have kids that end up with complications from illnesses.

 

Their fevers lasted for 24-48 hours. The "sickest" child right now is obviously feeling better because he's playing instead of going to sleep (all 3 of the boys in that room are a bit wild right now; I need to get them outside tomorrow!) The dc that were sick last week only felt badly for 1-2 days and were totally fine after that. That's why I was wondering how long it's normal to see swollen tonsils after an illness. They aren't acting sick (they were able to do their full loads of schoolwork last week plus played outside quite a bit) so I hesitate to take them to the doctor.

 

Thanks for your help!

 

BTW, my dh is convinced that there should be an over-the-counter rapid strep test so that we know whether or not to go to the doctor. Does such a thing exist? I told him I didn't think so because false negatives are possible and you need to let it culture.

[DianeW88]

They're probably ok, and if you feel that it's nothing serious, mommy instinct is usually right.

 

Over the counter rapid strep tests would be fairly worthless. First of all, a parent would have to correctly swab the throat and then correctly operate the test. Also, the rapid strep test is a test to detect antibodies to strep. If you haven't had the infection long enough, they won't show up. That is why all offices will also do a throat culture in a lab over a 72 hour period to see if strep bacteria is actually present.

 

Also, rapid strep tests can show the presence of strep even after an infection is long gone, because antibodies hang around for awhile. So, if you are having a child re-tested for a persistent strep infection, make sure the office is doing an actual culture and not another rapid strep test. Those can show positive for up to six weeks after an infection.

[Jpoy85]

I dont know about the strep, but i know about the huge tonsils. L had hers removed last year. The ENT had a 1-4 scale and hers were a 3. HUGE. I didnt even notice how big they were until she stuck a cracker in her mouth and i was watching. (it was one of those " mommy look at me" things).

 

I would get them removed if need be. Its a simple in and out procedure. L was out within 30mins and she did have to stay the hospital overnight but it was due to UNrelated issues. She needed some children tylenol for a day or two after but everything went fine.

 

Advice: IF any of your DC had a sippy cup and they have their tonsils removed- give them a straw instead! I didnt even think about how it would hurt Ls mouth/throat/jaw to suck from a sippy rather than a straw.

[lotsofpumpkins]

They're probably ok, and if you feel that it's nothing serious, mommy instinct is usually right.

 

Over the counter rapid strep tests would be fairly worthless. First of all, a parent would have to correctly swab the throat and then correctly operate the test. Also, the rapid strep test is a test to detect antibodies to strep. If you haven't had the infection long enough, they won't show up. That is why all offices will also do a throat culture in a lab over a 72 hour period to see if strep bacteria is actually present.

 

Also, rapid strep tests can show the presence of strep even after an infection is long gone, because antibodies hang around for awhile. So, if you are having a child re-tested for a persistent strep infection, make sure the office is doing an actual culture and not another rapid strep test. Those can show positive for up to six weeks after an infection.

 

Good to know, thanks!