Tonsillitis

What is tonsillitis?

Tonsillitis is an inflammatory disease. It occurs when your tonsils become infected by a virus or bacteria. Tonsils are the oval-shaped areas of pink tissue at the back of your throat. There are two tonsils, one on each side. They help fight infection by reacting to germs that enter through your nose and mouth. Infected tonsils become inflamed and swollen.

Tonsillitis is more common in children than adults.

What are the symptoms of tonsillitis?

Swollen tonsils often are the first sign of tonsillitis. It may feel like your throat or neck glands are swollen. Other symptoms may include:

  • redness
  • sore throat
  • white or yellow spots or film on your tonsils
  • trouble swallowing
  • fever
  • chills
  • bad breath
  • ear pain
  • headache
  • hoarse voice or loss of voice (laryngitis)
  • trouble sleeping or sleep apnea (when breathing stops briefly during sleep).

Children who have tonsillitis may have stomach pain. This is more common when strep is the cause of tonsillitis.

Contact your doctor if your child has symptoms of tonsillitis. This includes:

  • A sore throat that lasts more than two days (with or without a fever or stomach pain).
  • A fever above 103°F.
  • Extreme illness, fatigue, or weakness.
  • Labored breathing or swallowing.

If your child can’t breathe or is drooling because they can’t swallow, get emergency care right away.

What causes tonsillitis?

Viral infections cause most cases of tonsillitis. For example, the virus that causes mononucleosis, or mono, (called the Epstein-Barr virus) can cause tonsillitis. Bacterial infections only cause tonsillitis about 15% to 30% of the time. The main bacteria are a certain type of streptococcus, or strep. In these cases, the illness may be called strep throat.

How is tonsillitis diagnosed?

Contact your doctor if you or your child has symptoms of tonsillitis. Your doctor will ask about symptoms. They will check your ears, nose, and throat for swelling and signs of infection.

Your doctor will use a swab to take a sample from the back of your throat. The sample may be used for a rapid strep test or a throat culture. Both tests can show if your infection is caused by strep or another bacteria. A rapid strep test only takes a few minutes to show results. A throat culture must be sent to a lab and takes 24 hours or more. It is more reliable than a rapid stress test, which can give a false negative result. The doctor may order both tests to ensure a diagnosis.

In some cases, your doctor may do a blood test to determine the cause. For example, a blood test can check for mono.

How is tonsillitis treated?

Treatment for tonsillitis varies based on the cause. For a bacterial infection, the doctor will prescribe antibiotics. Be sure to follow your doctor’s orders and take all of the medicine on time. If you don’t, your infection may come back. Antibiotics also help reduce your risk of infecting others. You won’t be contagious after about 24 hours of treatment. If tonsillitis is caused by a virus, antibiotics won’t help.

There are some things you can do at home to help relieve your symptoms.

  • Drink plenty of fluids. This includes warm, soothing liquids, such as soup, broth, or tea with honey and lemon.
  • Eat soft foods, especially if it hurts to swallow.
  • Gargle with warm salt water (1/4 teaspoon of salt in 8 ounces of warm water).
  • Take acetaminophen or ibuprofen for fever and pain. Keep in mind that children younger than 18 years of age should not take aspirin. It can cause a serious illness called Reye’s syndrome.
  • Suck on a throat lozenge or hard candy.
  • Use a cool-misthumidifier to moisten the air.
  • Rest your body and your voice.

If your tonsils are so swollen that it’s hard to breathe, your doctor may prescribe steroids.

Can tonsillitis be prevented or avoided?

Tonsillitis is not contagious, but the infections that cause it are contagious. It is spread through contact with other people. You can prevent getting and giving it by:

  • Washing your hands often.
  • Not sharing food and drink with others.
  • Avoiding close contact with people who are sick.

Living with tonsillitis

Surgery to remove the tonsils (tonsillectomy) used to be common. Today, doctors only recommend surgery if tonsillitis is severe or recurring (chronic). A tonsillectomy is an outpatient surgery, meaning you don’t have to stay in the hospital.

If tonsillitis is left untreated, pus can collect in the back of your throat behind your tonsils. This is called an abscess. If you have an abscess, your doctor will need to drain it with a needle. In some cases, you may need a tonsillectomy to remove the abscess.

Questions to Ask Your Doctor

  • What is the cause of my tonsillitis?
  • How long does it take to get test results? What do the test results mean?
  • What medicines can I take and what are the side effects?
  • Is there anything else I can do to relieve my symptoms?
  • My child gets tonsillitis a lot. Do they need surgery to remove their tonsils?
  • What are the benefits and risks of a tonsillectomy?
  • If I have mono or strep throat, will I get tonsillitis?