A variety of bacterial and viral infections can cause tonsillitis. You may experience symptoms like sore throat and pain while swallowing.

Your tonsils are the two small organs made of lymphoid tissue located on each side of the back of your throat. They work as a defense mechanism and help prevent your body from getting an infection.

When an infection develops on your tonsils themselves, the condition is called tonsillitis.

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

The germs that trigger tonsillitis can be transmitted to others, and a variety of common viruses and bacteria can cause it. Tonsillitis-causing microorganisms include Streptococcal bacteria. Tonsillitis caused by strep throat can lead to serious complications without treatment.

Tonsillitis is easy to diagnose. Symptoms usually resolve within 7–10 days.

Here’s what you need to know about tonsillitis, from its symptoms to treatments that can help.

The 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, the tonsils are also vulnerable to infection from the very germs they help keep away.

A virus, such as the common cold, can trigger tonsillitis. Bacterial infections, such as strep throat, are also possible causes of tonsillitis.

Possible symptoms of tonsillitis include:

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

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, less often, a tonsillectomy.

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


Surgery to remove the tonsils is called a tonsillectomy. Doctors generally only recommend a tonsillectomy if you experience chronic or recurrent tonsillitis, or if tonsillitis has caused complications or symptoms don’t improve.

If you’ve had tonsillitis or strep throat at least five to seven times in the past year, a tonsillectomy may help stop these recurrences. The surgery can also relieve the breathing or swallowing problems 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 review of past studies. However, a 2018 study found that adults who underwent the procedure as children faced an increased risk of respiratory and infectious diseases long term.

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

You should be able to go home the same day as your surgery, though kids might not always be. It takes about 1–2 weeks to fully recover. Learn what to do before and after getting a tonsillectomy.

Tonsillitis antibiotics

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

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

If a doctor prescribes antibiotics for you, it’s likely to be penicillin for tonsillitis due to group A streptococcus, the bacteria that cause strep throat. Antibiotics are necessary for strep throat due to the risk of rheumatic heart disease. Other antibiotics are available if you have a penicillin allergy.

It’s important that you complete the full course of antibiotics. Even if your symptoms appear to be completely resolved, the infection can get worse if you don’t take all of the medication as prescribed.

Your doctor may want to schedule a follow-up visit to make sure that the antibiotics were effective.

A doctor will examine your throat to reach a diagnosis. They may also take a throat culture by gently swabbing the back of your throat. The culture is sent to a laboratory to identify the cause of your throat infection.

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

Tonsillitis can present in several different ways.

Acute tonsillitis

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 fewer, a doctor will consider it acute tonsillitis. If symptoms last longer, or if tonsillitis comes back multiple times during the year, it may be chronic or recurrent tonsillitis.

The symptoms of acute tonsillitis usually improve with home treatments. But, in some cases, you may require other treatments, like antibiotics.

Chronic tonsillitis symptoms continue longer than the acute type. You may have the following symptoms on a long-lasting basis:

  • sore throat
  • halitosis (bad breath)
  • 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 a doctor may need to remove them.

A 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 6–7 times in 1 year
  • occurrences of at least 5 times in each of the previous 2 years
  • occurrences of at least 3 times in each of the previous 3 years

A 2018 review suggests that chronic and recurrent tonsillitis may occur due to biofilms in the folds of the tonsils. Biofilms are communities of microorganisms that have developed antibiotic resistance, and they 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. Researchers found that genetics may cause an insufficient immune response to group A streptococcus bacteria, which cause strep throat and tonsillitis.

Learn more about the genetics behind recurrent tonsillitis.

Talk with a doctor if you experience the following symptoms:

  • a fever that’s higher than 103°F (39.5°C)
  • muscle weakness
  • neck stiffness
  • a sore throat that doesn’t resolve 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 resolve without treatment, some may require other treatments.

Tonsillitis isn’t contagious, but the infectious organisms that cause it may still be able to transmit to others until you’re no longer sick.

After around 24 hours of taking antibiotics, the bacteria won’t be able to transmit to other people.

You can develop tonsillitis if someone carrying a pathogen coughs or sneezes near you, and you breathe in the droplets. If you touch an object that potentially contains infectious organisms, like a doorknob, and then touch your nose or mouth without washing your hands first, you may also develop tonsillitis.

Being in contact with a lot of people increases the risk of exposure to the bacteria and viruses that cause tonsillitis. This is why school-aged children often get the illness. If you have symptoms, it’s best to stay home to avoid transmitting tonsillitis.

It typically takes 2–4 days to develop symptoms after exposure. Find out how to reduce your risk of getting or transmitting tonsillitis.

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, including:

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

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

Bacterial tonsillitis

Bacterial tonsillitis is most common in children between the ages of 5 and 15 years. Around 15–30% of tonsillitis cases in this age group result from bacteria. Most often, it’s strep bacteria, which cause strep throat. But other bacteria can also cause tonsillitis.

A 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.

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

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

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

Both conditions are contagious, so try to avoid being near 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

A 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.

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

Frequent exposure to other people increases the risk of encountering a person with tonsillitis. As a result, doing activities alongside large groups of people might 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.

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:

  • Tonsillar cellulitis: It’s possible the infection will worsen. This is known as tonsillar cellulitis.
  • Peritonsillar abscess: The infection can cause a person to develop a buildup of pus next to the tonsils, called a peritonsillar abscess. This can require drainage and surgery.
  • Obstructive sleep apnea (OSA): People who have chronic tonsillitis may start to experience obstructive sleep apnea. This happens when the airways swell and prevent a person from sleeping well, which can lead to other medical issues without treatment.

In addition to these, complications caused by strep throat include rheumatic fever and poststreptococcal glomerulonephritis.

Taking your medications as instructed by your doctor can reduce your risk of these complications.

To decrease your risk of getting tonsillitis:

  • Avoid people with active symptoms: And if you have tonsillitis, try to keep your distance from others until the pathogens are no longer transmissible.
  • Practice good hygiene: Make sure 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 breathlessness, which may lead to disturbed sleep. Without treatment, tonsillitis-causing bacteria can spread to the area behind the tonsils or to the surrounding tissue.

Symptoms of tonsillitis due to a bacterial infection usually improve a few days after you begin taking antibiotics. The infection is considered transmissible until you’ve been taking antibiotics for a 24-hour period.

Viral tonsillitis generally resolves on its own with supportive care.