What should you know about acute membranous tonsillitis?

The term describes sudden tonsil inflammation with a visible white, grey or cream coating that may form a sheet-like layer. Tonsillitis can present with sore throat, fever, painful swallowing and swollen neck glands. Streptococcal infection is one possible cause, but viral infections and less common bacterial illnesses can look similar. Appearance alone cannot determine the organism or whether antibiotics will help.

Arrange prompt medical examination and mention recent travel, vaccination history, close contact with a similar illness, rash, marked fatigue or neck swelling. Do not scrape or peel the coating because this may cause bleeding and does not treat the cause. Sip cool fluids and choose soft foods if swallowing is comfortable. Paracetamol or ibuprofen may help pain or fever when appropriate; use the label directions and seek pharmacy advice for children, pregnancy, other medicines or long-term health conditions. Do not share cups, utensils or towels while an infection is suspected.

Call emergency services for breathing difficulty, noisy breathing, blue or grey lips, confusion or rapidly increasing neck swelling. Urgent assessment is also needed if you cannot swallow saliva, are drooling, have a muffled voice, struggle to open the mouth, become dehydrated or feel severely unwell. Keep away from close contact with others and call ahead before attending if a clinician has raised concern about a contagious bacterial infection requiring isolation measures.

Ask whether a throat swab or other test is appropriate and what cause the examination suggests. If antibiotics are prescribed, confirm how to take the full course, what to do after a missed dose and which reaction needs help. Also ask when normal contact, school or work can resume and whether household members need advice.