No child should have to deal with chronic sore throats. Any chronic illness takes kids out of their daily routine, and sore throats can be exceptionally painful. Maybe you’ve visited your family doctor and heard them attribute your child’s sore throats to strep throat, sinusitis, tonsillitis or all three at different times. What’s the difference?

A Simple Breakdown

  • Tonsillitis: is an infection of the tonsils caused by any virus or bacteria. It can be acute or chronic. Infections that cause tonsillitis can travel and cause sinusitis.
  • Strep throat: is a specific bacterial infection of the throat. It can be acute or recurring. Because it infects tissues of the throat, strep can cause tonsillitis.
  • Sinusitis: is an infection of the sinuses caused by any virus or bacteria. It can be chronic or acute. Infections that cause sinusitis can travel and cause tonsillitis.

strep throatTonsillitis

Tonsils are immune tissue that help the body detect and react to any germs we might eat, drink or inhale. When they detect a threat, they tell our bodies to launch its initial immune responses. There are four sets, but we usually think of “tonsils” as the pair near the back of our throats. Adenoids, which are farther back and high up in the airway, are also tonsils.

Our tonsils are constantly exposed to bacteria and viruses. While it’s normal for them to swell a little while we’re fighting off an infection, the tonsils themselves can become infected, too. This is called tonsillitis.

Signs of tonsillitis include:

  • Inflamed tonsils
  • Severe sore throat
  • Bad breath
  • Difficulty swallowing
  • Pus on the tonsils
  • Fever
  • Enlarged cervical lymph nodes

Tonsillitis becomes chronic when an infection takes hold in the folds of the tonsil tissue. It’s also possible for the tonsils to become enlarged without being infected. This condition, called hypertrophy, is often caused by allergies. It can lead to breathing difficulties, obstructive sleep apnea and chronic ear infections.

Strep Throat

Strep is caused by the specific bacterial strain Streptococcal pharyngitis. It’s highly contagious, spreading when someone coughs, sneezes, shares drinks or touches near their mouth or nose before touching a shared surface. It’s a common late winter and early spring infection, and children are more susceptible to it than adults.

Doctors can easily test for strep using a throat swab and a quick, in-office test. The tests don’t check for strep directly. They check to see if the body is producing antibodies chemically designed to fight the strep bacteria. Because majority of sore throats are caused by viruses, antibiotic prescriptions are usually reserved for confirmed strep infections.

Signs of strep include:

  • Sore throat
  • Fever
  • Pus on the tonsils
  • Enlarged cervical lymph nodes

Strep throat can become recurrent under a handful of conditions, but it’s often linked to tonsillitis. The strep takes hold in your child’s tonsils and comes back repeatedly. It can also become recurrent in children with weakened immune systems or in families where one family member is an asymptomatic carrier. Carriers can have and spread the strep virus and not even know it.


In our skulls are six cavities called sinuses. We have one above each eyebrow, one at the inside corner of each eye and one on either side of our nose. They’re filled with mucous membranes, which we rely on to secrete the mucous that keeps the air we breathe into our lungs warm, moist and free from unwanted debris.

When germs get trapped in our mucous membranes, the membranes get infected. This is called sinusitis, or a sinus infection. They’re more common in children with allergies as their mucous membranes are constantly inflamed. The chronic inflammation prevents proper drainage, and the trapped germs set up shop.

Signs of sinusitis include:

  • Sore throat
  • Fever
  • Stuffy nose
  • Runny nose with yellow, green or bloody mucous
  • Ear pain and infection
  • Pain and pressure around the sinuses

Chronic sinusitis is usually linked to allergies. However, because the sinuses and tonsils are close to each other, it’s common for infection to travel between the two. Chronic infection in one can easily cause infection in the other. Children’s shorter airways make it even easier for infection to spread this way.

Seeking Treatment

Many children grow out of chronic sore throats as their immune systems get stronger. For children with chronic concerns, treatments like antibiotics, antihistamines and possible procedures like tonsillectomy could be indicated to help them get back to their normal activities.

To get your child in to see a specialist, contact Pediatric ENT of Oklahoma at (405) 608-8833 or use our online form to schedule an appointment.