What are Tonsillitis?

Tonsils are the two lymph nodes located on each side of the back of your throat. They function as a defense mechanism. They help prevent your body from infection. When the tonsils become infected, the condition is called tonsillitis.

Tonsillitis can occur at any age and is a common childhood infection. It is most often diagnosed in children from preschool age through their midteens. Symptoms include a sore throat, swollen tonsils, and fever.

This condition is contagious and can be caused by a variety of common viruses and bacteria, such as Streptococcal bacteria, which causes strep throat. Tonsillitis caused by strep throat can lead to serious complications if left untreated.

Tonsillitis is easily diagnosed. Symptoms usually go away within 7 to 10 days.

Causes of Tonsillitis

Tonsils are your first line of defense against illness. They produce white blood cells to help your body fight infection. The tonsils combat bacteria and viruses that enter your body through your mouth. However, tonsils are also vulnerable to infection from these invaders.

Tonsillitis can be caused by a virus, such as the common cold, or by a bacterial infection, such as strep throat. According to the American Academy of Family Physicians (AAFP), an estimated 15 to 30 percent of tonsillitis cases are due to bacteria. Most often it’s strep bacteria.

Viruses are the most common cause of tonsillitis. The Epstein-Barr virus can cause tonsillitis, which can also cause mononucleosis.

Children come into close contact with others at school and play, exposing them to a variety of viruses and bacteria. This makes them particularly vulnerable to the germs that cause tonsillitis.

Symptoms of Tonsillitis

There are several types of tonsillitis, and there are many possible symptoms that include:

  • a very sore throat
  • difficulty swallowing or painful swallowing
  • a scratchy-sounding voice
  • bad breath
  • fever
  • chills
  • earaches
  • stomachaches
  • headaches
  • a stiff neck
  • jaw and neck tenderness due to swollen lymph nodes
  • tonsils that appear red and swollen
  • tonsils that have white or yellow spots

In very young children, you may also notice increased irritability, poor appetite, or excessive drooling.

There are two types of tonsillitis:

  • recurrent tonsillitis: multiple episodes of acute tonsillitis a year
  • chronic tonsillitis: episodes last longer than acute tonsillitis in addition to other symptoms that include:
    • chronic sore throat
    • bad breath, or halitosis
    • tender lymph nodes in the neck

When to see a doctor

In rare cases, tonsillitis can cause the throat to swell so much that it causes trouble breathing. If this happens, seek immediate medical attention.

See a doctor if you experience the following symptoms:

  • fever that’s higher than 103˚F (39.5°C)
  • muscle weakness
  • neck stiffness
  • sore throat that doesn’t go away after two days

While some tonsillitis episodes go away on their own, some may require other treatments.

Tonsillitis Diagnosis

Diagnosis is based on a physical examination of your throat. Your doctor may also take a throat culture by gently swabbing the back of your throat. The culture will be sent to a laboratory to identify the cause of your throat infection.

Treatment for Tonsillitis

A mild case of tonsillitis does not necessarily require treatment, especially if a virus, such as a cold, causes it.

Treatments for more severe cases of tonsillitis may include antibiotics or a tonsillectomy.

Antibiotics will be prescribed to fight a bacterial infection. It’s important you complete the full course of antibiotics. Your doctor may want you to schedule a follow-up visit to ensure that the medication was effective.


Surgery to remove the tonsils is called a tonsillectomy. This was once a very common procedure. However, tonsillectomies today are only recommended for people who experience chronic or recurrent tonsillitis. Surgery is also recommend to treat tonsillitis that doesn’t respond to other treatment, or tonsillitis that causes complications.

If a person becomes dehydrated due to tonsillitis, they may need intravenous fluids. Pain medicines to relieve the sore throat can also help while the throat is healing.

Home care tips to ease a sore throat

  • drink plenty of fluids
  • get lots of rest
  • gargle with warm salt water several times a day
  • use throat lozenges
  • use a humidifier to moisten the air in your home
  • avoid smoke

Also, you may want to use over-the-counter (OTC) pain medications, such as acetaminophen and ibuprofen. Always check with your doctor before giving medications to children.

Complications of Tonsillitis

People who experience chronic tonsillitis may start to experience obstructive sleep apnea. This happens when the airway swells and prevents a person from sleeping well. It’s also possible the infection will worsen and spread to other areas of the body.

This is known as tonsillar cellulitis. The infection can also cause a person to develop a buildup of pus behind the tonsils, which is known as peritonsillar abscess. This can require drainage and more surgery.

If a person doesn’t take a full course of antibiotics or the antibiotics don’t kill off the bacteria, it’s possible a person could develop complications. These include rheumatic fever and poststreptococcal glomerulonephritis.

Prevention of Tonsillitis

Tonsillitis is highly contagious. To decrease your risk of getting tonsillitis, stay away from people who have active infections. Wash your hands often, especially after coming into contact with someone who has a sore throat, or is coughing or sneezing. If you have tonsillitis, try to stay away from others until you are no longer contagious.

Outlook for Tonsillitis

Swollen tonsils may cause difficulty breathing, which can lead to disturbed sleep. Tonsillitis left untreated can result in the infection spreading to the area behind the tonsils or to the surrounding tissue.

Symptoms of tonsillitis caused by a bacterial infection usually improve a few days after you begin taking antibiotics. Strep throat is considered contagious until you have been taking antibiotics for a 24-hour period.