What should you know about exudative tonsillitis?

The coating on the tonsils is called exudate. Tonsillitis with exudate can occur with viral infections or bacterial infections such as strep throat; glandular fever and other illnesses can also produce a similar appearance. Sore throat, fever, swollen glands, earache and difficulty swallowing may occur. The coating itself cannot establish the cause, and a person with exudative tonsillitis does not automatically need antibiotics. A GP may assess the throat, glands, hydration and overall illness, with testing when appropriate.

Arrange a GP consultation when pain is significant, fever persists, swallowing is difficult, or symptoms are not improving. Until reviewed, rest, drink frequent small amounts, choose soft foods and use suitable pain relief as directed. Avoid sharing cups and cutlery, and wash hands. Do not scrape the coating from the tonsils. If antibiotic treatment is prescribed for a confirmed or strongly suspected bacterial infection, take it exactly as directed and complete the course unless the prescriber changes it. Antibiotics do not treat viral tonsillitis.

Get emergency help for breathing difficulty, inability to swallow saliva, drooling, a muffled voice, rapidly worsening swelling, or inability to open the mouth normally. Seek prompt advice for dehydration, severe one-sided throat pain, persistent fever, a spreading rash or unusual drowsiness. These features can signal a complication or a different illness needing prompt examination.

Ask what causes are being considered, whether a throat test is useful, whether you need antibiotic treatment, how long you may be infectious, and which symptoms should bring you back urgently.