Tonsillitis patient overview

Overview

Tonsillitis is an infection that makes your tonsils — the two small glands at the back of your throat — swollen and sore. It usually happens when a virus or bacteria gets into your throat.

Yes, tonsillitis is very common. Most people will have it at least once, especially during childhood.

Tonsillitis affects people of all ages, but it is most common in children between the ages of 5 and 15. Young adults and older adults can also get it.

Symptoms

Common symptoms

• Sore throat that can make swallowing painful
• Swollen, red tonsils – sometimes with white or yellow patches
• Fever and chills
• Headache
• Swollen glands in the neck
• Hoarse or muffled voice

Symptoms in children

• Tummy ache or nausea
• Drooling more than usual (if very young)
• Not wanting to eat or drink
• Irritability or fussiness

Symptoms in older adults

• Tonsillitis is less common in older adults, but symptoms may be more severe when it happens
• Higher risk of complications like dehydration or breathing trouble

Causes

Main causes

• Viruses – the same ones that cause the common cold, flu, or other respiratory infections
• Bacteria – most commonly group A streptococcus (strep throat)
• Less commonly, other germs like fungi or bacteria that cause mono (Epstein-Barr virus)

Risk factors

• Being a child or teenager
• Spending time in crowded places like schools or daycares
• Having a weakened immune system
• Close contact with someone who has tonsillitis or a sore throat

When to see a doctor

See a doctor urgently if:

• Call your local emergency number if you have trouble breathing, cannot swallow, or feel like your throat is swelling shut.
• See a doctor the same day if you have a very high fever, severe pain, or signs of dehydration.

Book a routine appointment if:

• Make an appointment if your sore throat lasts longer than a few days.
• If you get tonsillitis many times in a year (for example, 5 or more episodes), talk to your doctor about treatment options.

Diagnosis

A doctor can usually tell if you have tonsillitis by looking at your throat and asking about your symptoms. They may gently press on your neck to check for swollen glands.

Tests that may be done

• Throat swab – the doctor wipes the back of your throat with a cotton swab to test for bacteria like strep
• Rapid strep test – gives results in a few minutes
• Throat culture – takes a day or two to confirm bacteria
• Blood tests – only if the doctor suspects a more serious infection like mono

What to expect at your appointment

The exam is quick and usually not painful. The throat swab may cause a brief gagging feeling, but it is over in seconds.

Treatment

Treatment depends on the cause. Viral tonsillitis gets better on its own. Bacterial tonsillitis may need antibiotics. The main goal is to relieve symptoms and prevent complications.

Self-care at home

• Rest and drink plenty of warm fluids like tea or broth
• Gargle with warm salt water to soothe your throat (mix half a teaspoon of salt in a glass of warm water)
• Use over-the-counter pain relievers like paracetamol or ibuprofen – always follow the instructions on the bottle
• Suck on throat lozenges or ice chips to ease pain
• Avoid spicy, acidic, or very hot foods that can irritate

Medical treatments

If the cause is bacteria, your doctor may prescribe a course of antibiotics. It is important to finish the entire course, even if you feel better. Antibiotics are not effective against viruses. Doctors do not recommend specific medications over the counter – talk to your pharmacist or doctor about what is safe for you.

When is surgery considered?

If you get recurrent severe tonsillitis (for example, 7 or more episodes in one year, or 5 episodes per year for two years), your doctor may suggest a tonsillectomy – surgery to remove the tonsils. This is usually only considered after other treatments have not worked.

Living with this condition

While you have tonsillitis, rest as much as possible. Drink fluids regularly to avoid dehydration. A cool-mist humidifier in your room can help soothe a dry throat. Avoid smoke and fumes.

Lifestyle tips

• Wash your hands often to stop the infection from spreading
• Do not share cups, utensils, or toothbrushes with others
• Stay home from work or school until you have been fever-free for 24 hours (without fever-reducing medicine) or until your doctor says it is safe

Diet and exercise

Eat soft, cool foods like yogurt, applesauce, or smoothies. Avoid crunchy, spicy, or citrus foods that can sting. Light activity is fine when you feel better, but do not exercise hard until the infection has fully cleared.

Mental health and emotional wellbeing

Tonsillitis can be painful and frustrating, especially if it keeps coming back. It may cause missed school or work and can feel isolating. Talk to your doctor if you feel anxious or down because of repeated infections. Support from family and friends can also help.

Prevention

You cannot always prevent tonsillitis, but you can reduce your risk by washing your hands often, avoiding close contact with people who have sore throats, and not sharing personal items.

Vaccines

There is no vaccine specifically for tonsillitis, but getting vaccinated against the flu can help prevent viral infections that sometimes lead to tonsillitis.

Screening programmes

There is no routine screening for tonsillitis. You only need to be tested if you have symptoms, especially if your doctor suspects strep throat.

Complications

If left untreated

• Peritonsillar abscess – a pocket of pus that forms near the tonsil, causing severe pain and difficulty opening your mouth
• Spread of infection to the ear or sinuses
• Rheumatic fever – a rare but serious condition that can affect the heart and joints, usually from untreated strep throat
• Difficulty breathing or swallowing if swelling is severe

Long-term outlook

The outlook for tonsillitis is very good. Most people recover completely within a week with rest and home care. Even if you need antibiotics, you should feel better in a few days. For those with frequent infections, surgery can provide lasting relief.

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