Sore throat and swollen tonsils: what to know

Tonsils can enlarge while the immune system responds to a viral infection such as the Common Cold, Influenza, COVID-19 or Glandular Fever. Tonsillitis describes inflamed tonsils and may include redness, coating, fever, bad breath and painful swallowing. Strep Throat is a bacterial cause that a clinician may assess with an examination and, when appropriate, a swab.

A white coating does not identify the cause on its own. Cough, nasal symptoms, fatigue, fever, tender neck glands and the speed of onset all add context. Repeated or persistent enlargement deserves review, particularly when it affects sleep, eating or breathing.

Take frequent sips of water, choose cool or warm drinks according to what feels better, and eat soft foods. Gargling with warm salt water may help adults and older children who can gargle safely. Use labelled pain relief only if it is suitable for you; a pharmacist can check interactions and age restrictions.

Avoid sharing utensils and replace close-contact habits while you have fever or active symptoms. Do not scrape a tonsil coating, and do not use leftover antibiotics. If a bacterial infection is diagnosed, follow the prescribed course and ask what improvement to expect.

Get urgent help if you cannot swallow saliva, breathing is difficult, your voice sounds muffled, you cannot open your mouth normally, or one tonsil or side of the throat is rapidly becoming larger. Seek prompt advice for dehydration, severe pain, repeated episodes, or symptoms that are not settling.

Ask whether the tonsils look more consistent with a viral illness or Strep Throat, whether a swab is needed, how to manage pain, and which changes mean you should seek urgent care.