Tonsillitis most commonly affects children between preschool and mid-teenage years. Common signs and symptoms of tonsillitis are as follows:

• red, swollen tonsils
• white or yellow coating on tonsils
• patches on tonsils
• sore throat
• pain while swallowing
• fever
• an itchy throat or a muffled voice
• bad breath
• headache
• enlarged, tender glands (lymph nodes) in the neck
• possible irritability or a poor appetite among children too young to express themselves

1. recurrent tonsillitis, in which multiple episodes of acute tonsillitis occur in a year, with each episode lasting for 4 to 10 days.
2. chronic tonsillitis, in which episodes last longer than acute tonsillitis, with other symptoms like chronic sore throat, bad breath and tender lymph nodes in the neck.

Complications

• A middle ear infection (otitis media) - where fluid between the eardrum and inner ear gets infected by bacteria
• Difficulty breathing
• Disrupted breathing during sleep (obstructive sleep apnoea)
• Infection that spreads deep into the surrounding tissue (tonsillar cellulitis)
• Infection that results in a collection of pus behind a tonsil (peritonsillar abscess)

If tonsillitis is caused by group A streptococcus, the child has an increased risk of rare problems such as rheumatic fever, an inflammatory disorder that affects the heart, joints and other tissues; or an inflammatory disorder of the kidneys that results in inadequate removal of waste and excess fluids from blood.