Lingual tonsilitis is often caused by viral or bacterial infections. In many cases, it resolves without complications within a week. Rarely, it can cause complications like trouble breathing.

Lingual tonsillitis is inflammation of the lingual tonsils found near the back of your tongue. It usually resolves with or without treatment within a week. In rare cases, it can lead to complications like airway obstruction or the formation of a pus-filled abscess.

Tonsils are masses of lymph tissue in the back of your throat that act as the first defense against germs before they enter your digestive or respiratory tracts. White blood cells in your tonsils become active when they come into with potentially harmful germs in your throat. There are different kinds of tonsils.

Lingual tonsillitis is considered a rare cause of a sore throat that may develop after a viral or bacterial infection, though it’s possible that it’s often under-diagnosed as many people with a sore throat don’t see a doctor. Inflammation of your lingual tonsils has also been reported as a side effect of immunotherapy.

Read on to learn more about lingual tonsilitis, including symptoms, causes, and treatment options.

Types of tonsils

You have four sets of tonsils that make up a ring in the back of your throat. They are:

  • Lingual tonsils: behind the back of your tongue.
  • Palatine (faucial) tonsils: on each side of the back of your throat.
  • Adenoids (Nasopharyngeal tonsil): in the back of your nasal cavity.
  • Tubal tonsils: near the opening of your eustachian tubes, which connect your middle ears to your throat.
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Lingual tonsillitis can cause a sore throat. Additional symptoms caused by the swelling of your tonsils can include:

If the underlying cause is an infection, you may develop symptoms like:

Tonsilitis, in general, is usually caused by bacterial or viral infections. Lingual tonsilitis can develop from the same infections as palatine tonsilitis. Palatine tonsilitis is often referred to simply as tonsilitis.

Viral infections are the most common. Tonsilitis can be caused by many different types of viruses, such as:

The most common bacterial cause of tonsilitis is Streptococcus pyogenes. This bacterium also causes strep throat.

Another common cause of infection is laryngopharyngeal reflux, a form of acid reflux.

In a 2020 study, researchers reported three cases of lingual tonsilitis that developed as a side effect of immunotherapy drugs administered under the tongue to treat allergies.

Lingual tonsilitis is likely underdiagnosed since the lingual tonsils are only visible with a special tool called a laryngoscope. Most of the medical literature is on adults with this condition. It’s not clear whether this is due to it being more common in adults or because children are less likely to be checked for it.

Complications of tonsilitis are uncommon but can include:

Lingual tonsil abscesses are extremely rare but can be life threatening.

The National Health Service recommends seeing a doctor if tonsilitis symptoms don’t go away within 4 days or if you have repeated throat infections.

A doctor might suspect tonsilitis based on your symptoms. Tests that can help support your diagnosis include:

  • a throat swab to test for bacteria
  • a complete blood count to look for signs of infection
  • a physical exam where the doctor will:

Laryngoscopy is required for a definitive diagnosis of lingual tonsilitis. Laryngoscopy involves using a special camera to examine the structures in the back of your throat.

Lingual tonsilitis may not require any specific treatment if it isn’t causing complications. General ways you may be able to help ease symptoms include:

  • getting plenty of rest to help your body recover
  • staying hydrated and drinking plenty of fluids
  • taking over-the-counter pain relievers such as ibuprofen or acetaminophen (Tylenol)

Bacterial infections are often treated with antibiotics. Antibiotics are not effective for tonsilitis caused by viral infections.

Surgical removal of the tonsils may be considered for people with frequent infections.

The best way to prevent tonsilitis is to take steps to avoid contact with the viruses and bacteria that cause it.

You may be able to prevent tonsilitis by:

  • wearing a mask in areas where there’s a high risk of coming into contact with people who are sick
  • avoiding people with respiratory or throat infections when possible
  • avoiding sharing drinks, utensils, or food with people with strep throat or other contagious infections
  • getting vaccinated for viruses such as the flu and COVID-19
  • washing your hands regularly with soapy water

Here are some frequently asked questions people have about lingual tonsilitis.

Is lingual tonsillitis dangerous?

Tonsilitis usually has an excellent outlook if complications don’t develop. Very rarely, lingual tonsilitis can cause life threatening complications like airway obstruction or lingual tonsil abscess.

How long does lingual tonsillitis last?

Acute tonsilitis usually resolves within a week. A small number of people have tonsilitis for longer or have recurrent tonsilitis that may require surgical removal of the tonsils.

A doctor can diagnose lingual tonsilitis with a test called a laryngoscopy. They can also perform a throat swab to see if your throat infection is caused by bacteria. Bacterial infections can be treated with antibiotics.