Should his tonsils be removed?

Dr Strachan suggests:

There is a difference between throat infections and tonsillitis. In tonsillitis, the tonsils are the starting point of the infection and the infection is usually limited to the tonsils. A red throat in a child with a fever is not tonsillitis.

Viral tonsillitis is the most common form of tonsillitis in children younger than 2 years and should not be treated with antibiotics. It can be difficult to tell the difference between a viral and a bacterial tonsillitis but a throat swab will give the answer. The swab is taken from the back of the throat and then cultured in the laboratory to see if any bacteria grow.

There must be very good reason to remove tonsils in children younger than 4 years of age. I would consider a tonsillectomy in a young child if the tonsils touch in the midline of the throat, if the tonsils are so huge that they cause obstructed breathing, or if there is clear evidence of repeated, severe bacterial infection.

Tonsils are important for helping the immune system to prompt the white blood cells to perform their protective function. This function of the tonsils becomes less important as a child grows but the immune system does not suffer serious damage if the tonsils are removed. Anaesthetic is as safe for a 2-year-old as at any other age.