What is tonsillitis?

Tonsils are the two lymph nodes located on each side of the back of your throat. They function as a defense mechanism and help prevent your body from getting an infection. When tonsils become infected, the condition is called tonsillitis.

Tonsillitis can occur at any age and is a common childhood illness. It’s most often diagnosed in children from preschool age through their mid-teens. Symptoms include a sore throat, swollen tonsils, and fever.

This condition is contagious and can be caused by a variety of common viruses and bacteria, such as Streptococcal bacteria, which causes strep throat. Tonsillitis caused by strep throat can lead to serious complications if left untreated.

Tonsillitis is easy to diagnose. Symptoms usually go away within 7 to 10 days. Here’s what you need to know — from types to treatments.

There are 3 types of tonsillitis: acute, chronic, and recurrent.

Possible symptoms of tonsillitis include:

In very young children, you may also notice increased irritability, poor appetite, or excessive drooling.

Tonsillitis is incredibly common in children. In fact, almost every child will probably get tonsillitis at least once.

If symptoms last around 10 days or less, it’s considered acute tonsillitis. If symptoms last longer, or if tonsillitis comes back multiple times during the year, it may be chronic or recurrent tonsillitis.

Acute tonsillitis will likely improve with home treatments, but in some cases may require other treatments, like antibiotics.

Chronic tonsillitis symptoms continue longer than acute. You may experience long-lasting:

  • sore throat
  • bad breath (halitosis)
  • tender lymph nodes in the neck

Chronic tonsillitis may also cause tonsil stones, where materials like dead cells, saliva, and food build up in the crevices of your tonsils. Eventually, the debris can harden into small stones. These may come loose on their own, or they may need to be removed by a doctor.

Your doctor may recommend a tonsillectomy to surgically remove your tonsils if you have chronic tonsillitis.

As with chronic tonsillitis, a standard treatment for recurrent tonsillitis is a tonsillectomy. Recurrent tonsillitis is often defined as:

  • a sore throat or tonsillitis at least 5 to 7 times in 1 year
  • occurrences at least 5 times in each of the previous 2 years
  • occurrences a least 3 times in each of the previous 3 years

Research from 2018 suggests that chronic and recurrent tonsillitis may be caused by biofilms in the folds of the tonsils. Biofilms are communities of microorganisms with increased antibiotic resistance that can cause repeated infections.

Genetics may also be a reason for recurrent tonsillitis.

A 2019 study examined the tonsils of children who had recurrent tonsillitis. The study found that genetics may cause a poor immune response to group A streptococcus bacteria, which causes strep throat and tonsillitis.

Learn more about the genetics behind recurrent tonsillitis.

You should see a doctor if you experience the following symptoms:

  • fever that’s higher than 103°F (39.5°C)
  • muscle weakness
  • neck stiffness
  • a sore throat that doesn’t go away after 2 days

In rare cases, tonsillitis can cause the throat to swell so much that it causes trouble breathing. If this happens, seek immediate medical attention.

While some tonsillitis episodes go away on their own, some may require other treatments.

If you have tonsillitis, you may be contagious 24 to 48 hours before you develop any symptoms. You may still be able to spread the illness until you’re no longer sick.

If you take antibiotics for bacterial tonsillitis, you should stop being contagious after 24 hours.

You can develop tonsillitis if someone with the infection coughs or sneezes near you and you breathe in the droplets. If you touch a contaminated object, like a doorknob, and then touch your nose or mouth, you may also develop tonsillitis.

Being in contact with many people increases the risk of being exposed to tonsillitis. This is why school-age children often get the illness. If you have symptoms, it’s best to stay home to avoid spreading tonsillitis.

It typically takes 2 to 4 days to develop symptoms after being exposed to someone with tonsillitis. Find out how to reduce your risk of getting or spreading tonsillitis.

Tonsils are your first line of defense against illness. They produce white blood cells that help your body fight infection.

The tonsils combat bacteria and viruses that enter your body through your mouth and nose. However, tonsils are also vulnerable to infection from these invaders.

Tonsillitis can be caused by a virus, such as the common cold, or by a bacterial infection, such as strep throat.

Viral tonsillitis

Viruses are the most common cause of tonsillitis. The viruses that cause the common cold are often the source of tonsillitis, but other viruses can also cause it. These include:

Since the Epstein-Barr virus can cause both mononucleosis and tonsillitis, sometimes people with mono will develop tonsillitis as a secondary infection.

If you have viral tonsillitis, your symptoms may include coughing or a stuffy nose. Antibiotics won’t work on viruses, but you can treat standard symptoms by staying hydrated, taking over-the-counter pain medications, and resting to help your body heal.

Bacterial tonsillitis

Around 15 to 30 percent of tonsillitis cases result from bacteria. Most often it’s strep bacteria, which causes strep throat, but other bacteria can also cause tonsillitis.

Bacterial tonsillitis is more common in children between the ages of 5 and 15.

Your doctor can prescribe antibiotics to treat bacterial tonsillitis, though they may not be necessary. Besides antibiotics, treatment is the same for most cases of viral and bacterial tonsillitis.

Diagnosis is based on a physical examination of your throat. Your doctor may also take a throat culture by gently swabbing the back of your throat. The culture will be sent to a laboratory to identify the cause of your throat infection.

Your doctor may also take a sample of your blood for a complete blood count. This test can show whether your infection is viral or bacterial, which may affect your treatment options.

A mild case of tonsillitis doesn’t necessarily require treatment, especially if a virus, such as a cold, causes it.

Treatments for more severe cases of tonsillitis may include antibiotics or a tonsillectomy.

If a person becomes dehydrated due to tonsillitis, they may need intravenous fluids. Pain medicines to relieve the sore throat can also help while the throat is healing.


Surgery to remove the tonsils is called a tonsillectomy. It’s generally only recommended for people who experience chronic or recurrent tonsillitis, or for cases where tonsillitis causes complications or symptoms don’t improve.

If you’ve had tonsillitis or strep throat at least 5 to 7 times in the past year, a tonsillectomy may help. The surgery can also relieve breathing problems or trouble swallowing that can result from tonsillitis.

A tonsillectomy may reduce the number of throat infections in children during the first year after surgery, according to a 2017 study. However, a 2018 study found that adults who had their tonsils removed as children had increased risks of respiratory and infectious diseases long term.

Having a tonsillectomy may reduce your overall risk of developing strep throat. You can still get strep throat and other throat infections after your tonsils are removed, though. It’s also possible for your tonsils to grow back after surgery, but this is uncommon.

You should be able to go home the same day as your surgery, but it will take 1 to 2 weeks to fully recover. Learn what to do before and after getting a tonsillectomy.

Tonsillitis antibiotics

If a bacterial infection caused your tonsillitis, your doctor can prescribe antibiotics to fight the infection.

Antibiotics may help your symptoms go away slightly faster. However, they increase the risk of antibiotic resistance and may have other side effects, like an upset stomach. Antibiotics are more necessary for people at risk of complications from tonsillitis.

If your doctor prescribes you antibiotics, it’s likely to be penicillin for tonsillitis caused by group A streptococcus. Other antibiotics are available if you’re allergic to penicillin.

It’s important that you complete the full course of antibiotics. Even if your symptoms disappear entirely, the infection can get worse if you don’t take all of the medicine as prescribed. Your doctor may want you to schedule a follow-up visit to ensure that the medication was effective.

There are several treatments you can try at home to ease throat pain from tonsillitis:

Use throat sprays rather than lozenges for young children, and always check with your doctor before giving children medications. Find out more ways to care for tonsillitis at home.

Tonsillitis is most common in children because they come into close contact with others every day at school and play, exposing them to a variety of viruses and bacteria. However, adults can get tonsillitis too.

Frequent exposure to people increases the risk of encountering someone with the infection. As a result, taking public transportation or doing other activities alongside many people may increase your chance of being exposed to tonsillitis.

Symptoms of tonsillitis and treatments are similar for both adults and kids. If you get a tonsillectomy as an adult, though, it’s likely to take longer for you to recover than it would for a child. Learn what to do if you develop tonsillitis as an adult.

Tonsillitis and strep throat can be caused by the same bacteria in some cases, but they’re not the same thing.

A number of different bacteria or viruses can cause tonsillitis, including group A streptococcus bacteria. This same bacteria is the only cause of strep throat.

Both conditions are contagious, so you should try to stay away from other people if you think you have either one.

In addition to tonsillitis symptoms, people with strep throat may develop:

  • aches in other parts of the body
  • nausea
  • vomiting
  • small red spots at the back of the mouth
  • white pus around the tonsils
  • a rash

Your doctor can use the same tests to diagnose both conditions. Treatments for bacterial tonsillitis and strep throat are also similar. Learn more about the differences between tonsillitis and strep throat.

People who experience chronic tonsillitis may start to experience obstructive sleep apnea. This happens when the airways swell and prevents a person from sleeping well, which can lead to other medical issues if left untreated.

It’s also possible the infection will worsen and spread to other areas of the body. This is known as tonsillar cellulitis.

The infection can also cause a person to develop a buildup of pus behind the tonsils, called a peritonsillar abscess. This can require drainage and surgery.

If you don’t take a full course of antibiotics or the antibiotics don’t kill off the bacteria, it’s possible that complications could develop from tonsillitis. These include rheumatic fever and poststreptococcal glomerulonephritis.

To decrease your risk of getting tonsillitis, stay away from people who have active infections. If you have tonsillitis, try to keep away from others until you’re no longer contagious.

Ensure you and your child practice good hygiene habits. Wash your hands often, especially after coming into contact with someone who has a sore throat, or is coughing or sneezing.

Swollen tonsils may cause difficulty breathing, which can lead to disturbed sleep. Tonsillitis left untreated can result in the infection spreading to the area behind the tonsils or to the surrounding tissue.

Symptoms of tonsillitis caused by a bacterial infection usually improve a few days after you begin taking antibiotics. Strep throat is considered contagious until you’ve been taking antibiotics for a 24-hour period.