Tonsillitis

Tonsillitis is an infection that causes inflammation (redness and swelling) of the tonsils.

Tonsillitis is a common condition in children, teenagers and young adults.

What are the tonsils?

The tonsils are 2 small glands that sit on either side of the throat. In young children, they help to fight germs and act as a barrier against infection.

When the tonsils become infected, they stop it spreading further into the body.

As a child’s immune system gets stronger, the tonsils become less important and usually get smaller. In most people, the body is able to fight infection without the tonsils.

Sore throat self-help guide

Complete our self-help guide to check your symptoms and find out what to do next.

Sore throat

Before using this guide

If you’re asking on behalf of someone else, please make sure the person is:

  • conscious and alert
  • responding normally to you

If not, phone 999 and ask for an ambulance.

Coronavirus (COVID-19)

If you’re worried about coronavirus, read our coronavirus guidance.

Symptoms of tonsillitis

The symptoms of tonsillitis include:

  • a sore throat
  • pain when swallowing
  • earache
  • high temperature (fever) over 38°C (100.4°F)
  • coughing
  • headache
  • feeling sick
  • feeling tired
  • swollen, painful lymph glands in your neck
  • white pus-filled spots on the tonsils
  • bad breath
  • loss of voice or changes to your voice

Symptoms usually get better within 3 to 4 days.

When to get medical advice

Speak to your GP practice if:

  • symptoms last longer than 4 days and don’t show any signs of getting better
  • symptoms are severe – for example, if you’re unable to eat or drink due to the pain, or you have difficulty breathing
  • you keep getting throat infections

If your GP practice is closed, phone 111.

Diagnosing tonsillitis

If needed, your GP will examine your throat and ask you some questions about your symptoms. They may take a swab of your throat to check if its caused by a viral or bacterial infection. It’ll usually take a few days to get your results.

If you develop severe tonsillitis as a teenager or adult, your GP may recommend a blood test for glandular fever.

Treating tonsillitis

There’s no specific treatment for tonsillitis. It usually gets better on its own within a week.

Things you can do to help your symptoms

Do

  • take paracetamol or ibuprofen to help relieve pain
  • drink plenty of fluids
  • get plenty of rest

Always read the leaflet that comes with your medicine before taking it. Follow the recommended dosage instructions. If you’re not sure which treatments are suitable for you or your child, speak to a pharmacist for advice.

Treatments from your doctor

If test results show that your tonsillitis is caused by a bacterial infection, a short course of oral antibiotics may be prescribed.

If oral antibiotics do not help and your symptoms are getting worse, your GP may refer you to hospital for antibiotics to be given into a vein (IV antibiotics).

Surgery to remove the tonsils (tonsillectomy)

A small number of children and adults have tonsillitis for longer, or it keeps returning. This is called chronic tonsillitis and surgery may be needed.

Surgery to remove the tonsils (a tonsillectomy) is usually only recommended if:

  • you’ve had several severe episodes of tonsillitis over a long period of time
  • repeated episodes are disrupting normal activities

What causes tonsillitis?

Most cases of tonsillitis are caused by a viral infection, such as cold or flu.

Some cases can also be caused by a bacterial infection, typically a strain of bacteria called group A streptococcus bacteria.

Tonsillitis itself isn’t contagious, but the infections that cause it are.

How to prevent infections spreading

Do

  • wash your hands often, especially after touching your nose or mouth and before handling food
  • always sneeze and cough into tissues
  • throw used tissues away and wash your hands

Complications of tonsillitis

Complications of tonsillitis are rare and usually only occur if it’s caused by a bacterial infection. They’re usually the result of the infection spreading to another part of the body.

Possible complications of tonsillitis include:

  • quinsy (peritonsillar abscess) – an abscess (collection of pus) that develops between one of the tonsils and the wall of the throat
  • obstructive sleep apnoea (OSA) – where the walls of the throat relax during sleep, which causes breathing difficulties and poor sleep

Other complications of tonsillitis are very rare. They usually only occur if an underlying bacterial infection is left untreated.

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