Tonsillitis

Tonsillitis is when the tonsils at the back of your throat become red and swollen (inflamed). It can feel like a bad cold or flu and usually gets better on its own after a few days.

Key points

  1. Tonsillitis is a common childhood illness but teenagers and adults can get it too.
  2. It is usually caused by a viral infection, but sometimes it is caused by a bacterial infection.
  3. Treatment for tonsillitis is usually rest and pain relief, but you may need antibiotics if you have a bacterial infection.
  4. Surgical removal of your tonsils (tonsillectomy) may be considered if you get tonsillitis often.

What causes tonsillitis?

Viruses

Tonsillitis is usually caused by viruses, such as those related to colds. You can inhale the viruses through droplets in the air from people sneezing and coughing, or by contact with secretions from the nose or throat of people with the infection. Tonsillitis may also be part of glandular fever (Epstein-Barr virus); this is more common in teenagers.

Bacteria

The main type of bacteria causing tonsillitis is Streptococcus, which causes strep throat. If you have strep throat you need to take antibiotics. Untreated strep throat can lead to serious complications, such as rheumatic fever (which can cause permanent damage to your heart) or inflammation of your kidneys.

Maori and Pasifika children are more at risk of developing rheumatic fever and should see a doctor or nurse if they show any sign of sore throat.

What are the symptoms of tonsillitis?

Symptoms of tonsillitis
  • sore throat
  • red and swollen tonsils
  • hoarse or no voice
  • a high temperature (fever) of 38°C or above
  • difficulty swallowing
  • headache
  • swollen lymph nodes (glands) on either side of your neck
  • possibly pus on tonsils
  • possibly muscle aches and a feeling of being unwell
  • young children may say they have a tummy ache.
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When should I visit my doctor?

Maori and Pasifika children

Maori and Pasifika children are at higher risk of developing rheumatic fever and should see a doctor or nurse if they show any sign of a sore throat. Your child may need 10 days of antibiotics for a suspected strep throat to prevent rheumatic fever. 

All children

You should see your family doctor if your child has:

  • a sore throat and a high temperature (fever)
  • a sore throat that is not improving after 48 hours
  • not been drinking much for more than 24 hours, or you are worried about them being dehydrated
  • great difficulty swallowing
  • tender lumps in their neck that are getting bigger
  • any other symptoms you are concerned about.

Adults

You should see your family doctor if:

  • you have white pus-filled spots on the tonsils at the back of your throat
  • your sore throat is so painful it's difficult to eat or drink
  • your symptoms don't go away after 4 days.

If you are unsure what to do, phone Healthline on freephone 0800 611 116. Calls are answered by registered nurses or other health professionals.

How is tonsillitis treated?

Mild tonsillitis often doesn't need any treatment. However, it is important to drink plenty of water.

Self-care for tonsillitis

Rest

Children and adults need rest to recover from tonsillitis.

Fluids and food

Make sure the person with tonsillitis drinks plenty of fluids, mainly water, especially if there is fever. 

  • Offer cold drinks, sips of ice to suck or ice blocks. They may like some soft foods such as jelly, ice cream or custard.
  • Don’t worry if not much is eaten for a few days, as long as fluid intake is kept up. 
  • Children and older adults should be taken to the doctor if they have not managed to drink anything for 15 hours.
Medications

Pain relief medication such as paracetamol and ibuprofen eases pain and gargling with salt water or sucking pain relief lozenges may help to soothe a sore throat. Antibiotics are not usually needed to treat tonsillitis because tonsillitis is mostly caused by viruses and antibiotics only work against bacteria. Read more about medications for tonsillitis.

Surgery to remove the tonsils

An operation to remove the tonsils (tonsillectomy) may be considered if you have frequent bouts of tonsillitis. Read more about tonsillectomy.

Preventing tonsillitis

Other children or family members should be kept away from the person with tonsillitis if possible. To prevent the spread of infection, use good hygiene measures including:

  • regularly washing hands
  • not sharing eating utensils or drinking vessels
  • frequent cleaning of surfaces, particularly in the kitchen and bathroom.

Learn more

Healthline website Ministry of Health NZ, 2014
Tonsillitis NHS Choices, UK

References

  1. Antibiotics guide BPAC 2017
  2. Spinks A, Glasziou PP, Del Mar CB. Antibiotics for sore throat. Cochrane Database of Systematic Reviews 2013, Issue 11. Art. No.: CD000023. DOI: 10.1002/14651858.CD000023.pub4.
Credits: Health Navigator Editorial Team. Last reviewed: 23 Jul 2018