Stages of tonsillitis

Tonsillitis is inflammation of the tonsils. Early symptoms can include a [Sore Throat](/symptoms/sore-throat/), painful swallowing, red or enlarged tonsils, [Fever](/symptoms/fever/), tiredness, and tender [Swollen Glands](/symptoms/swollen-glands/) in the neck. White coating or spots may appear on the tonsils, but this finding does not by itself identify the cause. Viral infections are common; bacterial infection such as [Strep Throat](/conditions/strep-throat/) is another possibility. [Earache](/symptoms/earache/) can occur because throat inflammation is felt near the ear, but severe one-sided pain needs assessment.

Symptoms are often strongest early and then ease over the following days. Repeated episodes, symptoms that do not improve, or symptoms that return after improvement deserve a clinical review. The pattern in one person cannot confirm the cause in another.

Rest, drink regularly, and choose cool or soft foods if swallowing hurts. Use age-appropriate pain or fever relief only as advised for your health history, and avoid sharing cups, utensils, or toothbrushes while ill. Arrange a [GP Consultation](/treatments/consultations-and-assessment/gp-consultation/) if symptoms are severe, recurrent, or not easing. A clinician may examine the throat and decide whether testing is needed. [Antibiotic Treatment](/treatments/medical-management/antibiotic-treatment/) is used when a bacterial cause is diagnosed or judged likely; it does not treat viral tonsillitis.

Seek urgent help for difficulty breathing, inability to swallow saliva, drooling, a muffled voice, difficulty opening the mouth, severe one-sided swelling, or rapidly worsening neck pain. Get prompt advice if drinking becomes difficult, urine is unusually reduced, fever persists, or symptoms improve and then sharply worsen. These signs may indicate dehydration or a complication around the tonsil.

Ask what is most likely causing the inflammation, whether a throat test is useful, how to manage swallowing pain, when normal activities can resume, and what would warrant another examination.