Diagnosis and Treatment

How are enlarged tonsils and adenoids diagnosed?

A clinician will ask about the child’s symptoms and medical history and do a physical examination of the child’s ears, neck, mouth and throat. A throat culture can help determine if the infection is bacterial or viral.

A clinician can see if the tonsils are enlarged by looking inside a child’s mouth, however, adenoids are harder to see. The clinician may use an endoscope, a long, flexible tube with a light at the end to observe the adenoid. Other diagnostic tests could include an x-ray, blood test or sleep study.

What are the treatment options for enlarged tonsils and adenoids?

If diagnostic testing determines that the cause of the infection is bacterial, not viral, the clinician may prescribe antibiotics.

Because antibiotics are only effective in treating bacterial infections, treatment will focus on the child’s comfort if a virus is causing the inflammation.

Treatment options to reduce pain and swelling include:

  • acetaminophen
  • increased fluid intake
  • throat lozenges
  • nasal spray

If the child has frequent tonsil and adenoid infections, the health care provider may recommend a procedure called a tonsillectomy and adenoidectomy (T&A) in which chronically infected tissues are removed. Often, both the tonsils and adenoids are removed at the same time, but sometimes only one or the other is removed.