What are the first signs of tonsillitis?

Tonsillitis is inflammation of the tonsils at the back of the throat. Early symptoms can include a scratchy or painful throat, redness, swelling, white patches, unpleasant breath, and reduced appetite. Children may also become irritable, drool, or refuse food because swallowing hurts. [Sore Throat](/symptoms/sore-throat/) and [Swollen Glands](/symptoms/swollen-glands/) can occur with many infections, so symptoms alone cannot show whether the cause is viral or bacterial.

[Strep Throat](/conditions/strep-throat/) is one possible bacterial cause. Ear pain can be referred from the throat; see [Earache](/symptoms/earache/) for context.

Offer frequent sips of fluid and choose soft, cool foods if swallowing is uncomfortable. Rest, avoid sharing cups or utensils, and wash hands regularly. A pharmacist or clinician can advise on suitable pain or fever relief for the person’s age and medical history. Antibiotics are not useful for every cause, so do not use leftover medicine.

Arrange a [GP Consultation](/treatments/consultations-and-assessment/gp-consultation/) if symptoms are severe, keep returning, or do not start improving. Seek urgent care for difficulty breathing, inability to swallow fluids, drooling, severe one-sided throat swelling, muffled speech, or marked drowsiness. A high temperature with worsening weakness or dehydration also needs prompt assessment; learn more about [Fever](/symptoms/fever/).

Ask whether the appearance of the tonsils suggests a bacterial infection, whether a throat test is needed, how to manage pain safely, and when the person can return to school or work. Mention difficulty swallowing, ear pain, or repeated episodes.