You may have heard the terms tonsillitis and strep throat used interchangeably, but this is not accurate. You can have tonsillitis without having strep throat. Tonsillitis may be caused by group A Streptococcus bacteria, which is responsible for strep throat, but you could also get tonsillitis from other bacteria and viruses.

Keep reading to learn more about tonsillitis and strep throat.

Tonsillitis and strep throat have many similar symptoms. That’s because strep throat can be considered a type of tonsillitis. But people with strep throat will have additional, unique symptoms.

Symptoms of tonsillitisSymptoms of strep throat
large, tender lymph nodes in the necklarge, tender lymph nodes in the neck
sore throatsore throat
redness and swelling in the tonsilssmall red spots on the roof of your mouth
difficulty or pain when swallowingdifficulty or pain when swallowing
feverhigher fever than in people with tonsillitis
stiff neck body aches
upset stomachnausea or vomiting, especially in children
white or yellow discoloration on or around your tonsilsswollen, red tonsils with white streaks of pus
headacheheadache

Tonsillitis can be caused by a variety of germs, including viruses and bacteria. It’s most commonly caused by viruses, however, such as:

  • influenza
  • coronavirus
  • adenovirus
  • Epstein-Barr virus
  • herpes simplex virus
  • HIV

Tonsillitis is only one symptom of these viruses. Your doctor will need to run tests and review all of your symptoms to determine which virus, if any, is the cause of your tonsillitis.

Tonsillitis can also be caused by bacteria. An estimated 15-30 percent of tonsillitis is caused by bacteria. The most common infectious bacteria are group A Streptococcus, which cause strep throat. Other species of strep bacteria may cause tonsillitis as well, including:

  • Staphylococcus aureus (MRSA)
  • Chlamydia pneumoniae (chlamydia)
  • Neisseria gonorrhoeae (gonorrhea)

Strep throat is caused specifically by the group A Streptococcus bacteria. No other group of bacteria or virus causes it.

Risk factors for tonsillitis and strep throat include:

  • Young age. Tonsillitis caused by bacteria is most common in children ages 5 to 15.
  • Frequent exposure to other people. Young children in school or day care are frequently exposed to germs. Similarly, people who live or work in cities or take public transportation may have more exposure to tonsillitis germs.
  • Time of year. Strep throat is most common in the fall and early spring.

You can only have tonsillitis if you have tonsils.

In extreme cases, strep throat and tonsillitis can lead to the following complications:

  • scarlet fever
  • kidney inflammation
  • rheumatic fever

You may not need to see a doctor for tonsillitis or strep throat. In most cases, symptoms will resolve within a few days of home care, such as rest, drinking warm liquids, or sucking on throat lozenges.

You may need to see a doctor, however, if:

  • symptoms last longer than four days and show no signs of improvement or have gotten worse
  • you have severe symptoms, such as a fever over 102.6°F (39.2°C) or difficulty breathing or drinking
  • intense pain that won’t subside
  • you have had several cases of tonsillitis or strep throat in the past year

Your doctor will ask you about symptoms and do a physical exam. During the physical exam, they will examine your throat for swollen lymph nodes, and check your nose and ears for signs of infection.

If your doctor suspects tonsillitis or strep throat, they will swab the back of your throat to take a sample. They can use a rapid strep test to determine if you are infected with strep bacteria. They can get results within a few minutes. If you test negative for strep, your doctor will use a throat culture to test for other potential bacteria. The results of this test usually take 24 hours.

Learn more: Streptococcal screen »

Based on your test results and symptoms, your doctor should be able to give you a diagnosis.

Most treatments will relieve your symptoms instead of actually treating your condition. For example, you can use anti-inflammatory medications to relive pain from fever and inflammation, such as acetaminophen (Tylenol) or ibuprofen (Advil and Motrin).

To relieve symptoms of sore throat, you can try these home remedies:

  • rest
  • drink lots of water
  • drink warm liquids, such as broth, tea with honey and lemon, or warm soup
  • gargle with salty warm water
  • suck on hard candy or throat lozenges
  • increase humidity in your home or office by using a humidifier
Shop for humidifiers.

Tonsillitis

If you have tonsillitis caused by a virus, your doctor will not be able to treat it directly. If your tonsillitis is caused by bacteria, your doctor may prescribe antibiotics to treat the infection. Make sure to take antibiotics exactly as directed by your doctor.

Taking antibiotics will also help you reduce your risk of infecting other people. A research study involving 2,835 cases of sore throat showed that antibiotics reduced the duration of symptoms by an average of 16 hours.

In more extreme cases, your tonsils may be so swollen that you can’t breathe. Your doctor will prescribe steroids to decrease inflammation. If that doesn’t work, they will recommend a surgery called tonsillectomy to remove your tonsils. This option is used only in rare cases. Recent research also questions its effectiveness, with one study noting that tonsillectomy is only modestly beneficial.

Strep throat

Strep throat is caused by bacteria, so your doctor will prescribe an oral antibiotic within 48 hours of the illness starting. This will reduce the length and severity of your symptoms, as well as the complications and risk of infecting others. You can also use home remedies to manage the symptoms of inflamed tonsils and sore throat.

Tonsillitis and strep throat are both contagious, so avoid being around other people while you’re sick, if possible. With home remedies and lots of rest, your sore throat should clear up in a few days. See your doctor if your symptoms are extreme or persist for a long time.

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