Tonsillitis

What is tonsillitis?

Tonsillitis occurs when your tonsils become infected. Tonsils are the two small lumps of soft tissue — one on either side — at the back of your throat. You can see your tonsils in a mirror by opening your mouth and sticking out your tongue.

Part of your immune system, tonsils help trap germs that make you sick. When your tonsils become infected, they get swollen and sore, and swallowing may hurt. Tonsillitis is also called tonsillopharyngitis, but most people call it a sore throat.

Who gets tonsillitis?

Tonsillitis is most common in children, but it can affect people of all ages. Tonsillitis rarely occurs in children under the age of three.

How common is tonsillitis?

Tonsillitis is very common. Most people have tonsillitis at least once in their lifetime.

What does tonsillitis feel like?

The most common symptom is a very sore throat. You might feel quite tired and weak, like you have a bad cold or flu. People with tonsillitis may experience a host of other symptoms, which we’ll outline in the section below.

What are common tonsillitis symptoms?

Tonsillitis symptoms usually come on suddenly. They may include:

Sore or scratchy throat.
Pain or difficulty swallowing.
Red, swollen tonsils and throat.
Whitish spots on your tonsils — or a white, yellow or gray coating on your tonsils.
Fever above 100.4 degrees Fahrenheit (38 degrees Celsius).
Swollen lymph nodes (glands on the sides of your neck below your ears).
Stomachache or vomiting (more common in younger children).

Is tonsillitis viral or bacterial?

Tonsillitis can be viral or bacterial:

Viral tonsillitis: Viruses like colds and flus (influenza) cause up to 70% of tonsillitis cases.
Bacterial tonsillitis (strep throat): Bacteria, such as Group A Streptococcus, cause other cases of tonsillitis. Bacterial tonsillitis is commonly called strep throat. People without tonsils can still get strep throat.

Is tonsillitis contagious?

Yes. The viruses and bacteria that cause tonsillitis are highly contagious. They’re passed along by:

Kissing or sharing utensils, food or drink.
Coming into close contact with someone who’s sick.
Touching a contaminated surface and then touching your nose or mouth.
Inhaling tiny particles that become airborne when a sick person sneezes or coughs.

How is tonsillitis diagnosed?

To diagnose tonsillitis, your healthcare provider will:

Examine your throat for redness, swelling or white spots on your tonsils.
Ask about other symptoms you’ve had, such as a fever, cough, runny nose, rash or stomachache.
Look in your ears and nose for other signs of infection.
Feel the sides of your neck to see if your lymph nodes are swollen and tender.

After confirming a tonsillitis diagnosis, your provider will need to determine whether the infection results from a virus or bacteria (strep throat). To do this, they may request a bacteria culture test.

During this procedure, your provider will swipe the back of your throat with a long cotton swab to gather cells and saliva. Then, they’ll check the sample to see if it tests positive for Group A Streptococcus bacteria. If your results are positive, you have strep throat. If your results are negative, you have viral tonsillitis.

How is tonsillitis treated?

Tonsillitis treatment depends on what caused the infection. While symptoms of viral tonsillitis and bacterial tonsillitis can be similar, their treatments are different.

How is bacterial tonsillitis treated?

Healthcare providers treat bacterial tonsillitis (strep throat) with antibiotic medications. Antibiotics require a prescription. You usually take antibiotics orally (by mouth) for about 10 days. The most common antibiotics for strep throat are:

Penicillin.
Clindamycin.
Cephalosporin.

It’s very important to follow your healthcare provider’s instructions and take the full course of antibiotics, even if you’re feeling better after a couple of days. You must finish the antibiotics so the infection doesn’t come back, get worse or spread to another part of your body.

How is viral tonsillitis treated?

The antibiotics used to treat bacterial tonsillitis (strep throat) won’t work on tonsillitis caused by a viral infection. To relieve the symptoms of viral tonsillitis, your provider will recommend:

Plenty of rest.
Fluids to stay hydrated.
Over-the-counter pain relievers like ibuprofen or acetaminophen.
Throat lozenges.

What if I keep getting tonsillitis?

If you have chronic or recurring tonsil infections, your healthcare provider may recommend a tonsillectomy. This is a procedure to surgically remove your tonsils.

Does tonsillitis go away on its own?

In most cases, tonsillitis symptoms go away in three to four days. But if symptoms last longer, you should schedule a visit with your healthcare provider to rule out other, more serious issues.

How can I manage tonsillitis symptoms?

To relieve the symptoms of viral and bacterial tonsillitis, you can:

Take an over-the-counter pain reliever such as acetaminophen or ibuprofen.
Drink warm liquids, like tea, apple cider or broth.
Gargle with warm salt water.
Try throat lozenges.

Are there complications associated with tonsillitis?

Complications from tonsillitis are usually associated with strep throat and Streptococcal bacteria. They include:

Chronic tonsillitis. People who have tonsillitis more than seven times a year may have chronic tonsillitis. Healthcare providers may recommend surgery to remove your tonsils, especially if you’re snoring or having trouble sleeping at night.
Tonsil stones. If you’ve had infected or inflamed tonsils for a long time, you might develop tonsil stones. Tonsil stones are hard, calcified bits of bacteria and debris that hide in your tonsils’ nooks and crannies.
Scarlet fever. Strep throat can progress into scarlet fever, causing a red rash and fever. Scarlet fever occurs more often in children than adults, but it’s not common.
Peritonsillar abscess. In severe cases of tonsillitis, an abscess (a collection of pus) can form around your tonsil. Peritonsillar abscesses occur more often in adults and adolescents than in children. Providers often recommend surgery to drain the abscess.
Rheumatic fever. Although rare, rheumatic fever can occur if strep throat isn’t treated or you don’t complete the full course of antibiotics. Rheumatic fever occurs in children more often than adults. It can lead to permanent heart damage.
Spread of infection. When left untreated, Streptococcal bacteria can spread from your throat to your middle ear, sinuses or other parts of your body. This infection can lead to complications such as sinusitis, glomerulonephritis or necrotizing fasciitis.

How can I prevent tonsillitis?

While you can’t totally prevent tonsillitis, there are things you can do to reduce your risk. For example:

Wash your hands often, especially before touching your nose or mouth.
Avoid sharing food, drink, or utensils with someone who’s sick.
Replace your toothbrush regularly.

What can I expect if I have tonsillitis?

Most cases of viral tonsillitis clear up in a few days with fluids and plenty of rest. Antibiotics usually eliminate bacterial tonsillitis (strep throat) in about 10 days. Tonsillitis usually doesn’t cause any serious or lasting health problems.

How serious is tonsillitis in adults?

Tonsillitis isn’t more serious in adults compared to children. But adults may have certain risk factors that can increase their chance of developing it. These risk factors might include:

Age. People over the age of 65 are more vulnerable to infections of all kinds.
Still having your tonsils. You’re more likely to get tonsillitis if you never had them removed.
Having frequent contact with children. Parents, grandparents, teachers and others who work closely with children are more likely to get tonsillitis.

Adults are also more likely to develop peritonsillar abscesses as a result of tonsillitis.

How long will tonsillitis last?

Most of the time, tonsillitis symptoms go away in three to four days. As mentioned above, be sure to call your healthcare provider if your symptoms last longer than that.

When should I see my healthcare provider?

You should contact your healthcare provider if you have:

Sore throat for more than four days.
Fever over 101 degrees Fahrenheit (38.33 degrees Celsius).
Trouble or pain when swallowing.
Difficulty breathing.
Painful or swollen tonsils.