Chronic tonsillitis is an ongoing infection of the tonsils. If you have chronic tonsillitis, you may need to have your tonsils removed.

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Tonsillitis is an infection of the tonsils. Tonsillitis generally lasts around a week. However, when it lasts longer than 14 days, it’s considered chronic tonsillitis.

Chronic tonsillitis may lead to other conditions that need additional treatment. If you have recurring bouts of tonsillitis, you may need to have your tonsils surgically removed.

Read on for more information about chronic tonsillitis and what to do if you think you have it.

Tonsillitis is an infection of the tonsils, the round organs at the beginning of your throat, at the back of your mouth. They are lymphoid tissues, such as lymph nodes, responsible for helping fight infections. When your tonsils become enlarged and inflamed, it’s called tonsillitis.

Chronic tonsillitis is an infection of the tonsils that lasts longer than a week or two. It may last weeks or months.

Recurrent tonsillitis, on the other hand, is if you have tonsil infections five or more times a year. These recurrent infections may not last for as many days as chronic tonsillitis.

The main symptom of chronic tonsillitis is a sore throat that lasts for more than 2 weeks. Other symptoms may include:

To diagnose tonsillitis, your healthcare professional will do a physical exam of your throat and tonsils. During the exam, they may also perform a throat culture by gently taking a sample of mucus from the back of your throat using a long swab. They will send the sample to a lab to see if you have an infection in your tonsils.

They may also take a blood sample and send it to the lab for testing. A test called a complete blood count can help your healthcare professional determine if the infection is caused by a virus or bacteria. These results will help them know which medications to prescribe and what other treatment options may be best for you.

When to see a healthcare professional

While tonsillitis may resolve on its own, there are circumstances when you may need to seek medical care, such as:

  • if your tonsillitis lasts longer than 4 days
  • if you develop white spots on your tonsils
  • if you have a fever of 101°F (38.3°C) or higher

Seek emergency care for a child with tonsillitis who has:

  • difficulty breathing
  • excessive drooling
  • pain that prevents them from eating or drinking
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While tonsillitis may resolve without treatment in a week or less, you’ll need to see a healthcare professional if you have chronic tonsillitis. Treatment options for chronic tonsillitis include:

  • oral antibiotics if the infection is caused by bacteria
  • home remedies for symptom relief, such as:
    • saltwater gargle
    • over-the-counter pain relievers
    • throat lozenges
    • oral sprays
  • surgery to remove your tonsils (tonsillectomy)

Although rare it’s rare, complications of chronic tonsillitis can occur. These may include:

If your chronic tonsillitis is caused by strep, these complications may occur:

Most people with chronic tonsillitis respond to treatment depending on what type of infection they have. Some people with chronic tonsillitis may need surgery to remove their tonsils.

Recovery from this surgery is usually around 10 days, but it may be longer, especially for adults.

How can I tell if I have strep throat or tonsillitis?

Strep throat is a subset of tonsillitis that can be called acute or chronic streptococcal tonsillitis.

Tonsillitis caused by strep may feel worse and include symptoms such as nausea and vomiting. Tonsillitis caused by a virus, on the other hand, may include respiratory symptoms such as a runny nose, postnatal drip, and a cough. Your healthcare professional can order tests to determine which you have.

The treatment may be different since strep throat is caused by group A Streptococcus (group A strep), a type of bacteria, and tonsillitis is most often caused by a viral infection.

Is tonsillitis more serious in adults or children?

Tonsillitis is more common in children than adults, but it’s not necessarily more serious when it occurs in adults. However, if an adult has chronic tonsillitis and needs a tonsillectomy, the recovery may be more complicated. Adults may be more likely to experience bleeding following tonsillectomy.

Can chronic tonsillitis mean I have cancer?

Cancer of the tonsils, also called oropharyngeal cancer (OPC), is extremely rare, so it’s unlikely that chronic tonsillitis is OPC.

OPC tends to be unilateral (in one tonsil), while chronic tonsillitis tends to be bilateral (in both tonsils).

The risk factors for OPC include:

  • smoking
  • having HPV
  • being over 50 years old
  • drinking alcohol

Note that HPV-mediated OPC tends to be more common in younger men than OPC caused by smoking or drinking.

Tonsil cancer may present like tonsillitis. If you have throat pain that lasts longer than 2 or 3 weeks, a painless lump on the side of your throat, or symptoms of chronic tonsillitis, see your healthcare professional.

Chronic tonsillitis is an infection of the tonsils that lasts longer than 14 days. Chronic tonsillitis may lead to other complications.

It’s important to seek medical care if you have a sore throat or other symptoms of tonsillitis that don’t go away within a few days.

Some people with chronic tonsillitis may need to have their tonsils surgically removed.