Think tonsillitis is just for kids? Think again
- Reviewed by Howard E. LeWine, MD, Chief Medical Editor, Harvard Health Publishing; Editorial Advisory Board Member, Harvard Health Publishing
Just about every child gets tonsillitis at least once. But sore, red, inflamed tonsils can happen to anyone, including adults of any age. Here's what you need to know about tonsillitis symptoms, treatment, and self-care methods you can use at home for much-needed relief.
What is tonsillitis?
Tonsillitis is inflammation and swelling of the tonsils, the two round or oval, slightly pinkish lymph glands in the top back part of your mouth.
These glands help prevent viruses and bacteria from infecting you. But when an infection takes hold in the throat, it can cause your tonsils to swell. By far, the most common bacterial cause of tonsillitis is Streptococcus (known as strep throat).
Symptoms of tonsillitis
Common tonsillitis symptoms include:
- difficulty or pain with swallowing
- sore throat
- fever
- visible redness or swelling in the back of the mouth
- swollen lymph glands in the neck
- white or yellow patches or pus on your tonsils
- bad breath
- breathing through your mouth or snoring
- feeling tired or lethargic.
Any throat infection can lead to swelling of the tonsils. Reasons to suspect strep throat is the likely cause are a very sore throat, marked difficulty swallowing, fever, and body aches along with tonsillar swelling.
Acute versus chronic tonsillitis
The symptoms of acute tonsillitis usually come on suddenly, with the onset of an infection, then go away after a few days to one week. Symptoms of chronic tonsillitis or recurrent tonsillitis linger for weeks, or resolve but come back repeatedly.
Experts don't yet understand what makes some people more likely to develop chronic tonsillitis or recurrent tonsillitis.
If you have chronic tonsillitis, you might feel like your sore throat never goes away. The lymph nodes in your neck may remain tender to the touch, and you might notice debris on your tonsils called tonsil stones. Tonsil stones look like small white or yellow pebbles and may cause bad breath in addition to a sore throat.
In some severe (but rare) cases of tonsillitis, adolescents and adults may develop what's called a peritonsillar abscess, a pocket of pus within one tonsil. This can make your sore throat even worse. It can also cause drooling, trouble opening your mouth, or changes in the sound of your voice.
Diagnosing tonsillitis
Call your doctor's office or go to urgent care if you have sudden onset of a very sore throat, fever, body aches, and marked pain or difficulty when you swallow. Otherwise, you can call for advice if symptoms persist or are getting worse over the next two to three days.
If you do need medical evaluation, the clinician will start by asking about your symptoms and health history. They will examine your throat looking for inflammation and redness, and check both sides of your neck for swelling or tenderness.
Most likely, the clinician will perform a rapid strep test with a result available while you are in the office. If it is positive, the clinician will prescribe antibiotics. You can have strep throat with a negative rapid test. If your symptoms and throat exam are highly suggestive of strep, the clinician will send out a culture and may choose to still recommend antibiotics.
Adolescents and adults may also be tested for certain sexually transmitted infections that could cause tonsil swelling.
Treating tonsillitis
Your test results help determine the best tonsillitis treatment for you. If you have strep throat, you'll be prescribed an antibiotic to fight the bacterial infection. You'll usually start to notice your symptoms improve within two to three days of starting the antibiotics.
If your doctor thinks it's more likely you have a viral infection, you won't be prescribed antibiotics. Your doctor might recommend over-the-counter treatments to manage throat discomfort.
Treating chronic tonsillitis
Surgically removing the tonsils used to be more common. Now, surgery is typically only recommended for people with chronic tonsillitis or many episodes of recurrent tonsillitis. Called a tonsillectomy, the procedure doesn't require a hospital stay. An otolaryngologist, or ear, nose, and throat specialist, will help determine if you're a good candidate for tonsil removal.
If you develop a peritonsillar abscess, you might need to have the pus surgically drained from around your tonsil.
Home remedies
While you're waiting for antibiotics to kick in or for a viral infection to pass on its own, you can try the following home remedies for tonsillitis symptom relief.
- Drink lots of fluids.
- Try warm liquids or cold, soft foods to soothe your throat.
- Get plenty of rest.
- Gargle with saltwater.
- Suck on lozenges or cough drops (this generally isn't recommended for young children).
- Consider over-the-counter pain relievers.
- Don't smoke or do anything else that could irritate your throat.
Preventing tonsillitis
Tonsillitis itself isn't contagious, but cold viruses or strep bacteria that may cause a sore throat and tonsil inflammation certainly are. One of the best ways to avoid these infections is to wash your hands frequently.
Try to avoid close contact with people you know are sick, or consider wearing a mask if you have to be around them. And avoid sharing food and drinks with others to limit your exposure to germs that could spark tonsillitis.
About the Author
Sarah Klein, Health Writer
About the Reviewer
Howard E. LeWine, MD, Chief Medical Editor, Harvard Health Publishing; Editorial Advisory Board Member, Harvard Health Publishing
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