What should you know about unilateral tonsillitis?

Tonsillitis inflames the tonsils at the back of the throat. One side may hurt more, look larger or develop a white coating. A sore throat, fever, swollen neck glands, earache and pain when swallowing can accompany it. Strep throat is one possible bacterial cause, while viruses are also common. Severe one-sided pain, a muffled voice, drooling, difficulty opening the mouth or a tonsil pushed toward the middle can suggest an abscess beside the tonsil and needs prompt assessment. Appearance alone cannot identify the cause.

Sip cool or warm fluids, choose soft foods, rest your voice and avoid smoke. Gargling with warm salty water may soothe an adult or older child who can gargle safely. Use suitable pain or fever relief according to the label and your clinician's advice. Arrange a GP consultation if symptoms are severe, keep returning, make eating or drinking difficult, or do not begin to improve. Antibiotic treatment is used only when a bacterial cause is considered likely or confirmed.

Get emergency help for trouble breathing, inability to swallow saliva, drooling, rapidly increasing throat or neck swelling, a muffled voice, severe dehydration or difficulty opening your mouth. Seek prompt medical advice for persistent one-sided swelling, high fever with worsening pain or marked difficulty swallowing. These signs can reflect an abscess or another problem requiring treatment.

Does this look like viral tonsillitis, strep throat or an abscess? Do I need a throat test? Which pain relief is safe for me? What swallowing or breathing changes should trigger urgent care?