What should you know about acute follicular tonsillitis?

The appearance alone cannot reliably identify the germ. A clinician considers the examination and accompanying symptoms before deciding whether testing or prescription treatment is warranted.

This illness can present with a painful throat, fever, tender neck glands, bad breath and difficulty swallowing. Pain may be felt in the ear even when the ear itself is healthy. Cough, a runny nose or hoarseness can help shape the clinical assessment but do not settle the cause by themselves.

A throat examination checks the tonsils, surrounding swelling and whether one side looks different from the other. Depending on the findings, a swab or other test may be considered.

Sip cool or warm fluids, choose soft foods and rest. Gargling warm salty water may soothe an adult or older child who can gargle safely. A pharmacist can advise on suitable pain relief and throat products, taking account of age, pregnancy, allergies and existing medicines.

Do not use leftover antibiotics or share them. If a bacterial cause is diagnosed and antibiotics are prescribed, take them exactly as directed and seek advice if a rash, breathing problem or severe diarrhoea develops.

Get emergency help for breathing difficulty, noisy breathing, inability to swallow saliva, drooling, severe drowsiness or rapidly increasing throat swelling. A muffled voice, trouble opening the mouth, or marked swelling on one side needs urgent assessment because infection may have spread beside the tonsil.

Contact a clinician when drinking is difficult, urine becomes scant or dark, symptoms worsen after initial improvement, or fever and throat pain are not settling. People with reduced immunity should seek advice earlier.

Ask whether the pattern suggests a viral or bacterial infection, whether a throat test would change treatment, and which pain relief is compatible with your medicines. Clarify when normal activities can resume and which signs should prompt a same-day review.