Tonsillitis
Tonsillitis is an infection of the tonsils that causes a very sore throat. Most common in
children, tonsillitis can affect all ages. Treatment depends on the cause of the infection
What is tonsillitis?
Tonsillitis occurs when the tonsils become infected and inflamed.
Tonsils are the two small lumps of soft tissue — one on either
side — at the back of the throat. You can see your tonsils in a
mirror by opening your mouth and sticking out your tongue.
As part of your immune system, tonsils trap some of the germs
that make you sick. When tonsils become infected, they get
swollen and sore, and swallowing may hurt. Tonsillitis is also
called tonsillopharyngitis, but most people call it a sore throat.
How common is tonsillitis?
Tonsillitis is very common. Most people have tonsillitis at least
once in their lifetime.
Who is affected by tonsillitis?
Tonsillitis is most common in children, but it can affect people of
all ages. Tonsillitis rarely occurs in children under the age of 3.
What are the symptoms of tonsillitis?
Symptoms of tonsillitis usually come on suddenly. Common
symptoms include:
• Sore or scratchy throat
• Pain or difficulty swallowing
• Red, swollen tonsils and throat
• Whitish spots on the tonsils, or a white, yellow or gray
coating on the tonsils
• Fever above 100.4 degrees
• Swollen lymph nodes (glands on the sides of your neck
below your ears)
• Stomachache or vomiting (more frequently in younger
children)
What causes tonsillitis?
A virus or bacteria causes tonsillitis. The two types of tonsillitis
are:
• Viral tonsillitis: Most cases (up to 70 percent) of tonsillitis
are caused by a virus such as cold or flu (influenza).
• Bacterial tonsillitis (strep throat): Other cases of tonsillitis
are caused by group AStreptococcus bacteria. Bacterial
tonsillitis is commonly called strep throat.
How do people get tonsillitis?
The viruses and bacteria that cause tonsillitis are highly
contagious. They are passed along by:
• Kissing or sharing utensils, food or drink
• Coming into close contact with someone who is sick
• Touching a contaminated surface and then touching your
nose or mouth
• Inhaling tiny particles that become airborne when a sick
person sneezes or coughs
How is tonsillitis diagnosed?
To diagnosis tonsillitis, your doctor will:
• Examine your throat for redness, swelling or white spots on
the tonsils
• Ask about other symptoms you’ve had, such as a fever,
cough, runny nose, rash or stomachache
• Look in your ears and your nose for other signs of infection
• Feel the sides of your neck to see if the lymph nodes are
swollen and tender
After confirming a tonsillitis diagnosis, your doctor will need to
determine whether the infection results from a virus or bacteria
(strep throat).
How is strep throat diagnosed?
Your doctor may order a throat culture — also known as a strep
test — to determine if you have strep throat. A throat culture is a
simple test that checks for the presence of specific bacteria in
your throat. During a throat culture:
1. Your doctor will swipe the back of your throat with a long
cotton swab to gather saliva and cells. The test may feel
uncomfortable, but it is not painful.
2. While you wait, your doctor will test the cells to check for
bacteria. This test is called a “rapid strep test.” The results
are ready in about 10-15 minutes.
3. If the results are positive and the test does detect bacteria,
your doctor will prescribe an antibiotic to treat you for strep
throat.
4. If the results are negative and the rapid strep test does not
detect bacteria, your doctor may send the sample away to a
lab for more thorough testing. This longer lab test usually
takes 2-3 days to get results.
5. If the lab test results come back negative, you’ll know the
tonsillitis is viral, not bacterial.
How do I know if I have tonsillitis?
If you have a sore throat, swollen tonsils and pain with
swallowing, you may have tonsillitis. You should visit your doctor
to determine whether bacteria or a virus is causing the tonsillitis.
The treatment varies based on the type of infection.
What are the treatments for tonsillitis?
The treatment you receive depends on the infection’s cause.
While the symptoms of viral tonsillitis and bacterial tonsillitis can
be similar, their treatments are different.
What is the treatment for strep throat?
Strep throat (tonsillitis caused by bacteria) is treated with an
antibiotic medication. Antibiotics require a prescription from your
doctor. You usually take antibiotics orally (by mouth) for about 10
days. The most common antibiotics for strep throat are:
• Penicillin
• Clindamycin
• Cephalosporin
It is very important to follow your doctor’s instructions and take the
full course of antibiotics, even if you are feeling better after a
couple of days. You must finish the antibiotics so the infection
doesn’t come back, get worse, or spread to another part of your
body.
What are the side effects of the treatment for strep throat?
Side effects from antibiotics used to treat bacterial tonsillitis (strep
throat) include:
• Upset stomach
• Diarrhea
• Vomiting
• Headache
• Vaginal itching and yeast infection
What is the treatment for viral tonsillitis?
The antibiotics used to treat strep throat (bacterial tonsillitis) will
not work on tonsillitis caused by a viral infection. To relieve the
symptoms of viral tonsillitis, your doctor will recommend:
• Plenty of rest
• Fluids to stay hydrated
• Over-the-counter pain relievers like ibuprofen or
acetaminophen
• Throat lozenges
What are the complications associated with tonsillitis?
Complications from tonsillitis are usually associated with strep
throat and the streptococcal bacteria. They include:
• Chronic tonsillitis: People who have tonsillitis more than 7
times a year may have chronic tonsillitis. Doctors may
recommend surgery to remove the tonsils, especially if you
are snoring or having trouble sleeping at night. This surgery
is called tonsillectomy.
• Scarlet fever: Strep throat can progress into scarlet fever,
causing a red rash and fever. Scarlet fever occurs more
often in children than adults, but it is not common.
• Peritonsillar abscess: In severe cases of tonsillitis, an
abscess (a collection of pus) can form around the tonsil.
Peritonsillar abscesses occur more often in adults and
adolescents than in children. Doctors often recommend
surgery to drain the abscess.
• Rheumatic fever: Although rare, rheumatic fever can occur
if strep throat is not treated or you don’t complete the full
course of antibiotics. Rheumatic fever occurs in children
more often than adults. It can lead to permanent heart
damage.
• Spread of infection: When left untreated, streptococcal
bacteria can spread from the throat to the middle ear,
sinuses, or other parts of the body. This infection can lead to
complications such as sinusitis, glomerulonephritis, or
necrotizing fasciitis.
What can I do to help relieve symptoms of tonsillitis?
To relieve the symptoms of viral and bacterial tonsillitis, you can:
• Take an over-the-counter pain reliever such as
acetaminophen or ibuprofen.
• Drink warm liquids, like tea, apple cider or broth.
• Gargle with warm salt water.
• Try throat lozenges
