tonsil with fever

Overview

Tonsils are two small glands at the back of your throat. When they become swollen and infected, you may have a sore throat and a fever. This is often called tonsillitis. It can be caused by viruses or bacteria and usually gets better within a week.

Yes, tonsillitis is one of the most common reasons people see a doctor for a sore throat, particularly in children.

It can affect anyone, but it is most common in children between about 5 and 15 years old. Teenagers and young adults also get it often.

Symptoms

Common symptoms

• Sore throat and pain when swallowing
• Red, swollen tonsils with white or yellow patches
• Fever (temperature above 100.4°F / 38°C)
• Swollen glands in the neck
• Bad breath
• Tiredness or feeling unwell

Symptoms in children

• High fever
• Tummy pain or vomiting
• Refusing to eat or drink
• Drooling more than usual (in younger children)
• Fussiness and crying more than usual

Symptoms in older adults

• Milder fever, but a sore throat that lasts longer
• Difficulty or pain when swallowing
• Raspy voice or hoarseness
• A feeling of something stuck in the throat

Causes

Main causes

• Viral infections, such as colds, flu, or glandular fever
• Bacterial infections, most commonly group A streptococcus (strep throat)
• Sometimes an infection caused by other bacteria

Risk factors

• Being a child or teenager
• Being in close contact with someone who has a sore throat
• Having a weakened immune system
• Exposure to smoke or dusty environments

When to see a doctor

See a doctor urgently if:

• Trouble breathing or feeling like your throat is closing
• Difficulty swallowing anything, even water
• Tonsils are so swollen they touch each other or block your view of the back of your throat
• You or your child has a seizure or is very drowsy

Book a routine appointment if:

• A sore throat that lasts more than a week
• A fever that lasts more than 3 days
• Frequent episodes of tonsillitis (for example, several in a year)
• A severe sore throat without other cold symptoms

Diagnosis

A doctor will ask about your symptoms, look at your throat to check your tonsils, feel your neck for swollen glands, and listen to your chest. Sometimes they will take a small swab from the back of your throat to test for bacteria.

Tests that may be done

• Throat swab (quick test for strep bacteria)
• Sometimes a blood test to help identify the cause
• No test is needed for many mild cases

What to expect at your appointment

The visit is usually quick. The doctor may shine a light in your mouth, gently press your tongue down with a wooden stick, and use a soft swab if a test is needed.

Treatment

Most tonsillitis clears up on its own within a week. Treatment focuses on easing pain, lowering fever, and making sure you drink enough fluids. If a bacterial infection is confirmed, a short course of antibiotics may be prescribed by your doctor. Never take antibiotics without a prescription.

Self-care at home

• Rest and drink plenty of fluids, especially water and warm drinks
• Take over-the-counter pain relief (ask your pharmacist which is safe for you)
• Gargle with warm salty water (if you are able to do so)
• Suck on lozenges or ice chips, but be careful with young children
• Avoid smoking or being around smoke

Medical treatments

If a bacterial infection is confirmed, antibiotics may be prescribed. Always finish the full course as directed. For severe or repeated cases, surgery to remove the tonsils (tonsillectomy) might be considered, but this is only after other options have been tried. Pain relief and fever-reducing medicines can be bought without a prescription and used as directed.

When is surgery considered?

Surgery to remove the tonsils is usually only considered if you or your child has had several severe episodes in a year, tonsillitis keeps coming back, or complications such as an abscess (a collection of pus) develop. Your doctor will explain the benefits and risks.

Living with this condition

Look after yourself at home, drink regularly, and rest. Keep your throat moist with warm drinks. Most people recover fully within a few days to a week. If you are caring for a child, encourage them to take small sips of fluids often.

Lifestyle tips

• Wash your hands frequently to reduce spreading the infection
• Keep eating and drinking to help your throat heal
• Avoid sharing cups, cutlery, or toothbrushes while you are ill

Diet and exercise

Eat soft, cool foods like yoghurt, smoothies, ice cream, or soup if swallowing hurts. Avoid spicy, salty, or rough foods. Gentle activities are fine if you feel up to it, but rest is more important until your fever goes.

Mental health and emotional wellbeing

Having a painful throat and fever can make you feel miserable, especially if eating and sleeping are difficult. That is normal. If you or a child are struggling with low mood or anxiety while ill, talk to your doctor or a trusted friend.

Prevention

You cannot fully prevent tonsillitis, but you can reduce the risk of catching or spreading infections by washing your hands, covering coughs and sneezes, and avoiding sharing drinks or utensils.

Vaccines

There is no vaccine that directly prevents tonsillitis. However, vaccines against flu and certain other infections can reduce overall colds and throat infections.

Screening programmes

There is no routine screening test for tonsillitis. Testing is based on symptoms and a doctor's assessment.

Complications

If left untreated

• Peritonsillar abscess (a collection of pus near the tonsil, causing severe pain and difficulty opening the mouth)
• Difficulty breathing in very rare cases
• Rare complications from strep infection, such as rheumatic fever, if not treated (modern care makes this very uncommon)

Long-term outlook

For most people, tonsillitis gets completely better within a week. Even when it comes back from time to time, it often becomes less frequent as you get older. If treatment is needed, it is very effective.

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