All you need to know about tonsillitis

All you need to know about tonsillitis

Tonsillitis is a common tonsil-infection.

The tonsils are located at the back of your throat. They are lymphoid tissue collections which form part of the immune system.

While tonsillitis may be painful and unpleasant, the condition is rarely a major concern for safety. Most people, whether they are taking medicine or not, should recover from tonsillitis within a few days. The majority of symptoms will improve in 7–10 days.

We ‘re explaining the causes, diagnosis and symptoms of tonsillitis in this article. We do include some medical information like tonsil removal.


A man having sore throat
A person with tonsillitis may experience a sore throat when swallowing.

The most common symptoms of tonsillitis include:

  • a sore throat and pain when swallowing
  • red and swollen tonsils with pus-filled spots
  • fever
  • headache
  • difficulty swallowing
  • pain in the ears and neck
  • tiredness
  • difficulty sleeping
  • coughing
  • chills
  • swollen lymph glands

Less common symptoms may include:

  • fatigue
  • stomach pain and vomiting
  • nausea
  • furry tongue
  • changes in the sound of the voice
  • bad breath
  • difficulty opening the mouth

Some people may grow tonsil stones which are also called tonsilloliths or tonsillar calculi by doctors. A tonsillolith is a calcified buildup of material in the crevices of the tonsils.

They are usually tiny but they can be larger in rare cases.

Tonsil stones can be a nuisance and sometimes hard to remove, but generally not harmful.

When to see a doctor

Tonsillitis can occasionally cause so much swelling in the throat that it becomes difficult to breathe. That is rare, but seek medical attention as a matter of urgency if this happens.

If a person has any of the following symptoms they should also visit their doctor:

  • a high fever
  • a stiff neck
  • muscle weakness
  • a sore throat that persists for longer than 2 days


tonsilitis symptom


A doctor will begin with a general examination to diagnose tonsillitis, and will check for swelling around the tonsils, often with white spots.

Doctors may also examine the outside of the throat for signs of swollen lymph glands, and occasionally a rash.

For closer inspection the doctor can take a swab from the infected area. Using this technique they can determine if it is viral or bacterial that causes the infection.

They may also do a complete count of blood cells. This procedure requires taking a tiny amount of blood to research levels of different blood cell types. Such blood test will help a doctor supplement the details from the swab that they obtained.

In some cases, a complete count of blood cell may help the doctor determine the best treatment if the swab is inconclusive.


If a person cannot treat tonsillitis at home, a range of treatment options is available.


People can use pain relieving drugs over-the-counter (OTC) to relieve the tonsillitis symptoms.

If tonsillitis is caused by a bacterial infection, a doctor may usually prescribe antibiotics. For a person with viral tonsillitis, however, they won’t do so. Antibiotics don’t work against viruses.

Penicillin is the antibiotic which is most common. When on an antibiotic course, a person has to follow the full course and continue to take it, even if the symptoms have been resolved. Stoping a part of the way through a course of antibiotics could allow the infection to spread.

Rarely, if left unchecked, specific species of bacteria may result to rheumatic fever or kidney inflammation.


Doctors previously suggested routine surgery to treat tonsillitis. A doctor will not recommend tonsillectomy today except if the condition is chronic and reoccurring.

Although the tonsils become less active after puberty, they are still a functional organ. A surgeon will not remove them for that reason, unless necessary.

A doctor can ask for a tonsillectomy if the tonsils cause side problems, such as:

  • sleep apnea, which involves problems breathing at night
  • difficulties with breathing or swallowing
  • an abscess that is difficult to treat
  • tonsillar cellulitis, in which the infection spreads to other areas and leads to a buildup of pus behind the tonsils

If tonsillectomy is needed, doctors can choose from a variety of methods. Medical practitioners have used lasers, electromagnetic waves, ultrasonic energy, cold temperatures or a heated needle effectively to remove the tonsils.

Surgery is becoming the last port of call more and more. The negative effects of the surgery can outweigh the tonsil removal positive.

Though tonsillitis can be distressing and painful when it occurs, it is going to pass for most people without any long-term consequences.

Home remedies

Several simple remedies can help a person reduce the tonsillitis symptoms at home:

  • Resting enables the body to preserve energy for fighting the infection rather than using it on daily activities.
  • Drinking plenty of fluids will prevent the throat from drying out and becoming more uncomfortable. When the body is responding to an infection, it needs more hydration than usual. Warm, preferably caffeine free drinks can also have a soothing effect.
  • Gargling with saltwater might reduce discomfort.
  • Sucking throat lozenges may help soothe the throat.
  • Dry air can irritate the throat. Using air humidifiers or sitting in a steamy bathroom can alleviate this.
  • Avoiding irritants, such as tobacco and smoky locations, can help a person reduce symptoms.
  • Taking medication, such as ibuprofen or acetaminophen, can help with pain and fever.


Tonsils are the first line of defense against any possible disease or infection. Because of this they can develop an infection quickly.

Tonsillitis is typically viral. Less commonly the infection can be caused by bacteria.

Viral or bacterial tonsillitis may be infectious and can spread from person to person. However, if a secondary illness, such as sinusitis or hay fever, causes tonsillitis, it is unlikely to spread.

Viral causes

The most frequent cause of the tonsillitis is a viral infection. The most prevalent forms of virus infecting tonsils include:

  • adenovirus, which is a possible cause of the common cold and sore throat
  • rhinovirus, which is the most common cause of the common cold
  • influenza, or flu
  • respiratory syncytial virus, which often leads to acute respiratory tract infections.
  • two subtypes of coronavirus, one of which causes SARS

Less commonly, the following can cause viral tonsillitis:

  • Epstein-Barr virus (EBV)
  • herpes simplex virus (HSV)
  • cytomegalovirus (CMV)

Bacterial causes

Streptococcus pyogenes seem to be the most prevalent type of bacteria to infect the tonsils. However, less often, other species can cause tonsillitis, including:

  • Staphylococcus aureus
  • Mycoplasma pneumonia
  • Chlamydia pneumonia
  • Bordetella pertussis
  • Fusobacterium
  • Neisseria gonorrhoeae


Different types of tonsillitis may occur. Doctors define them by their symptoms and recovery period.

These include:

  • Acute tonsillitis: Symptoms usually last around 3–4 days but may last up to 2 weeks.
  • Recurrent tonsillitis: A person has several different instances of acute tonsillitis in a year.
  • Chronic tonsillitis: Individuals will have an ongoing sore throat and foul-smelling breath.

Diagnosing the type of tonsillitis will help a doctor decide the best course of treatment.

Tonsillitis vs. strep throat

People often mistake strep throat for tonsillitis. There are however significant differences.

A particular type of bacteria called group A Streptococcus causes the throat to stretch. Symptoms also become more serious. Streptococcus may infect other parts of the throat, too.

Also, the viruses can cause tonsillitis. Strep throat, though, is purely a bacterial infection.


Complications may lead to bacterial tonsillitis. This is uncommon however, and typically happens in young people. Viral tonsillitis generally does not lead to complications.

The infection may spread and cause complications to other parts of the body including:

  • quinsy, or peritonsillar abscess, which is a build-up of pus between a tonsil and the throat wall
  • obstructive sleep apnea, in which the throat walls relax while a person is asleep and affect breathing and the sleep cycle

Rarer complications include:

  • scarlet fever
  • rheumatic fever, which causes inflammation throughout the body and leads to jerky body movements and pain in the joints
  • glomerulonephritis, in which the filtering mechanisms of the kidneys swell and trigger vomiting

Commonly, complications are rare. In most people tonsillitis clears up without a problem.


Can I spread tonsillitis through kissing?


Yeah, kissing will spread tonsillitis. Tonsillitis can develop from a virus or from bacteria.

Viruses and bacteria can spread through droplets from kissing, coughing, and sneezing. When you have tonsillitis you should stop kissing to prevent another person from spreading the virus or bacteria.