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

The pathogens that trigger tonsillitis can pass 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 to 10 days.

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

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 the very pathogens they help keep away.

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

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

Tonsillectomy

Surgery to remove the tonsils is called a tonsillectomy. Your physician will 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 5 to 7 times in the past year, a tonsillectomy may help you to 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 study. 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, 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 resolve your symptoms 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 due to 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 appear to be completely resolved, 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 make sure that the medication was effective.

Your doctor will examine your throat to reach a diagnosis. 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.

Tonsilitis 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 less, a physician 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 will likely improve with home treatments. But, in some cases, you may require other treatments, like antibiotics.

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

  • 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 a doctor may need to remove them.

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 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

Research from 2018 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. The study found that genetics may cause an insufficient 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 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 can pass to other people for 24 to 48 hours before you develop any symptoms. They may still be able to spread to others until you’re no longer sick.

After around 24 hours of taking antibiotics, the bacteria or virus 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, 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-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 exposure. Find out how to reduce your risk of getting or spreading 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 will develop tonsillitis as a secondary infection.

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 to 15 years. Around 15 to 30 percent of tonsillitis cases in this age group result from bacteria. Most often, it’s strep bacteria, which causes strep throat. But other bacteria can also cause tonsillitis.

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.

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 your doctor before giving children medications. Find out more ways to care for tonsillitis at home.

Tonsillitis and strep throat can occur as a result of 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 here.

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, taking public transportation or doing other 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 rheumatic fever and poststreptococcal glomerulonephritis, as well as:

  • Obstructive sleep apnea (OSA). People who experience 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.
  • Tonsillar cellulitis. It’s also possible the infection will worsen and spread to other areas of the body. This is known as tonsillar cellulitis.
  • Peritonsillar abscess. 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.

Taking prescribed medicines as instructed by your doctor can reduce your risk for these complications.

To decrease your risk of getting tonsillitis:

  • Stay away from people who are displaying active symptoms. If you have tonsillitis, try to keep away from others until the pathogens are no longer transmissible.
  • 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 pathogens 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.