Tonsillitis

What is tonsillitis?

Tonsillitis is inflammation of your tonsils. The tonsils are glands found at both sides of the back of your throat.

Your tonsils are part of your immune system and help protect your body against infection.

Tonsillitis makes your tonsils swollen and sore. It is most common in children. Adults can get tonsilitis, but it is not common.

 

What are the symptoms of tonsillitis?

Symptoms of tonsillitis include:

• a sore throat, which can very painful
• trouble swallowing
• fever
• red and swollen tonsils
• swollen lymph nodes (lymph glands) in your neck
• headache
• loss of appetite (not feel like eating)
• bad breath

What causes tonsillitis?

Tonsillitis is usually caused by viruses, often the same viruses that cause colds and flu.

Glandular fever, usually caused by the Epstein-Barr virus, can cause severe tonsillitis, usually in teenagers.

Tonsilitis can also be caused by bacteria. The most common type of bacteria involved is streptococcus (sometimes called ‘strep’ throat).

Is tonsillitis contagious?

Tonsillitis itself is not contagious, but the viruses and bacteria that cause tonsillitis can sometimes be spread to other people.

To avoid spreading infection, it’s important to:

• keep away from people while unwell
• wash your hands often
• keep the sick person’s eating and drinking utensils separate

If your child has tonsillitis they should stay at home until their fever has gone and they are able to swallow comfortably again. This will usually be 3 to 4 days.

When should I see my doctor?

If you think your child has tonsillitis for the first time, take them to their doctor. If your child has had tonsillitis before and they usually improve with care at home, you don’t always need to see their doctor.

See your doctor if you or your child:

• have a high fever
• have increasing pain, even after taking pain-relief medicines
• have increasing pain on one side of the throat
• are worried for any other reason

How is tonsillitis diagnosed?

To diagnose tonsillitis, your doctor will ask about your symptoms. They will also check for redness or spots on your tonsils and swollen lymph nodes.

Your doctor may take a throat swab to find out the cause of your tonsillitis. This is done by gently rubbing a sterile cotton swab (cotton wool on a stick) over your tonsils.

It can be difficult to tell tonsillitis apart from other viral infections that cause a sore throat (including COVID-19). A throat swab can help confirm the cause of a sore throat.

How is tonsillitis treated?

Your treatment will depend on the cause of your tonsillitis and how severe your symptoms are.

Antibiotics

If a virus has caused your tonsillitis, antibiotics will not help. But if your tonsillitis is caused by bacteria, you will need antibiotics.

Self-care measures

Paracetamol can help reduce pain, fever or headaches.

General measures to help you or your child recover include:

• getting plenty of rest
• drinking plenty of fluids to prevent dehydration
• gargling with warm salt water to relieve a sore throat — spit the water out afterwards
• eating soft, cool foods (such as ice cream and jelly), which can soothe a sore throat

Most people with tonsillitis can be cared for at home and will feel better in about a week.

Surgery

If you or your child gets tonsillitis a lot, surgery may be recommended to remove your tonsils. The operation is known as a tonsillectomy.

People who have a tonsillectomy need a general anaesthetic. Some people have the tonsillectomy as day surgery. Other people stay in hospital overnight.

A tonsillectomy is a very common surgery. However, all surgeries have some risks. You should discuss these with your doctor.

You should talk to your doctor about whether a tonsillectomy is likely to help you or your child.

Can tonsillitis be prevented?

There is no immunisation against tonsillitis. You can have it more than once.

See advice above for steps you can take to avoid spreading the viruses and bacteria that cause tonsillitis to other people.

Complications of tonsillitis

Sometimes tonsillitis is caused by a streptococcal bacterial infection. If left untreated, this kind of infection can cause complications, like:

• scarlet fever
• rheumatic fever

A middle ear infection is a common complication of tonsillitis.

An uncommon complication of tonsillitis is a peri-tonsillar or neck abscess (collection of pus). This can cause symptoms including:

• very sore throat that may be worse on one side
• fever
• neck pain (especially when moving your neck)
• difficulty opening your mouth
• painful swallowing, trouble swallowing or dribbling
• voice changes or difficulty speaking