When to worry about fever with tonsillitis

Tonsillitis may cause a hot or shivery feeling, red or swollen tonsils, throat pain, tender neck glands, and difficulty eating. It can be caused by different infections, so fever does not identify the cause by itself. A healthcare professional can assess the throat and decide whether testing is useful.

More concerning changes include fever that returns after a period of improvement, increasing swelling, or pain that becomes strongly one-sided. A muffled voice or difficulty opening the mouth may indicate infection around the tonsil rather than uncomplicated tonsillitis.

Offer regular drinks and cool or soft foods, and encourage rest. Follow the product instructions for any fever or pain medicine; children should not receive medicines intended for adults. Avoid forcing food, but monitor drinking and urination. If antibiotics are prescribed, follow the course and seek advice if symptoms worsen while taking them.

Get emergency help for noisy or difficult breathing, inability to swallow saliva, drooling, a rapidly enlarging throat or neck, blue lips, collapse, or marked confusion. These signs can threaten the airway or indicate a serious infection.

Contact a clinician promptly when drinking becomes difficult, urine becomes much less frequent, vomiting prevents fluids, fever is worsening or returns, or throat pain is severe on one side. Seek earlier advice for very young children or people with reduced immunity.

Ask what may be causing the tonsillitis, whether a throat test is needed, how much fluid the patient should aim to drink, and which changes should trigger same-day review.