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Complications of tonsillitis in children are rare. The most serious complications involve those that lead to breathing difficulty, which may result from:

• Enlarged tonsils (obstructive tonsil hyperplasia). May occur due to swelling of tonsils during infection. Tonsils usually return to their normal size after the infection has cleared. However, they may sometimes remain enlarged, especially in cases of repeated infections. Enlarged tonsils can block the airway, making breathing and swallowing difficult. It can cause sleep apnea, loud snoring, mouth breathing while sleeping and feeding problems. Complications may be especially severe when enlarged tonsils are combined with enlarged adenoids. Additional problems include a failure to thrive and speech problems. Surgery to remove the tonsils (tonsillectomy) may be required.
  
  
• Abscess. A collection or pocket of pus around the tonsils. This may occur when infection of the tonsils spreads into other areas of the throat. Swelling from the abscess may block airflow, causing breathing difficulty. Symptoms of an abscess near the tonsils include severe pain and significantly muffled speech. This type of abscess occurs more often in young adults than in children.

Dehydration may also occur as a result of tonsillitis when difficulty swallowing prevents a child from getting enough fluids.

Tonsillitis that is caused by the bacterial infection that causes strep throat and is left untreated may result in the following complications:

• Ear infections (otitis media)
• Scarlet fever
• Kidney inflammation, kidney failure
• Rheumatic fever