Tonsillitis: symptoms, causes and treatment

Tonsillitis is inflammation of the tonsils, usually caused by a viral or bacterial infection and often producing a sore throat.

The tonsils sit at the back of the throat and help recognise germs. They can become red, swollen, and sometimes develop white patches. Tonsillitis is different from every sore throat, although throat soreness is a very common presentation of tonsillitis.

Fever, sore throat, swollen glands, and difficulty swallowing are very common or common presentations of tonsillitis. Earache can occur because pain from the throat is felt in the ear. Children may eat less, become irritable, or drool if swallowing is uncomfortable.

Get urgent medical help if breathing is difficult, saliva cannot be swallowed, the voice becomes muffled, the neck is very swollen, or the person is unusually drowsy.

Viruses cause many cases. Bacteria can also infect the tonsils; streptococcal infection is one example. A clinician considers the whole pattern, including throat appearance, fever, cough, and close contacts, because symptoms alone cannot reliably identify the germ.

Many episodes improve with rest, fluids, and symptom relief. Recovery can be slower when pain makes drinking difficult. Recurrent episodes, one-sided worsening pain, or symptoms that fail to settle deserve a clinical review to check for another cause or a complication.

Close contact with someone who has a throat infection can increase exposure to the germs that cause tonsillitis. It is common where people spend time in close groups, including households and schools. Sharing cups or cutlery while someone is unwell can spread respiratory germs.

A clinician examines the mouth and neck and asks about the onset of symptoms, cough, rash, and swallowing. A throat swab or other test may be used when bacterial infection is suspected. The examination also checks for dehydration and signs of a collection of pus beside a tonsil.

Rest, regular fluids, and suitable pain relief can make swallowing easier. Antibiotics are used when a clinician thinks a bacterial infection needs treatment; they do not treat viral illness. Take prescribed medicine exactly as directed and seek advice if a rash, breathing difficulty, or troublesome side effect occurs.

Choose cool or soft foods if they are more comfortable, and encourage frequent small drinks. Avoid smoking and smoky environments while the throat is irritated. Stay home from close-contact settings while feeling unwell and follow local clinical advice about returning after a confirmed bacterial infection.

Occasionally, infection spreads into tissues around a tonsil and can cause increasing one-sided pain, difficulty opening the mouth, voice change, or drooling. These signs need same-day medical assessment. Repeated troublesome episodes may lead a specialist to discuss whether tonsil surgery is appropriate.

Wash hands after coughing, sneezing, or touching the face, and dispose of used tissues. Do not share drinking bottles or utensils during an illness. Cover coughs and sneezes, and clean commonly touched surfaces when someone in the household has a respiratory infection.

Arrange a GP assessment for severe throat pain, symptoms that are not improving, repeated episodes, or concern about dehydration. Emergency care is needed for breathing difficulty, inability to swallow saliva, or rapidly increasing throat or neck swelling.