Local complications also include the bacteria entering into the blood vessels which now allows more serious infections such as bone infections, meningitis and pneumonia. The differentiation between viral tonsillitis and Strep tonsillitis is important to prevent these possible complications. The history may give important clues but a swab of the back of the throat for a culture is a critical part of the evaluation. Most pediatricians have the Rapid Strep detection test in their offices. Therefore, if the rapid test is negative, a standard throat culture is recommended.
Some children have green nasal drainage, tonsillitis and fever.
Their cultures may grow bacteria other than the Group A Streptococcus. Although the infection is probably a complication of a viral tonsillitis, some of these children respond well to antibiotics. There is no specific treatment of viral tonsillitis. Pain control with Tylenol or motrin, and increased fluid intake are the basic recommendations. Gargling with warm salt water solutions may also offer some relief of the throat pain.