Tonsillitis

Overview

Tonsillitis is inflammation and infection of the tonsils at the back of the throat. It is common in children but can affect teenagers and adults. Most cases are caused by viruses, although bacteria such as group A strep can sometimes be responsible.

How common is it?

Tonsillitis is a common childhood illness, and teenagers and adults can get it too. The infections that cause it can spread between people, even though tonsillitis itself is not a separate contagious condition.

Causes and risk factors

Viruses that cause colds and flu are the usual cause. Bacterial infection, including strep throat, is less common. A clinician may need to consider other illnesses, such as glandular fever, when symptoms are severe or do not improve.

Common risk factors

• Close contact with people who have a cold, flu, or throat infection
• Being a child or young adult
• Repeated exposure in schools, households, or crowded settings
• A weakened immune system, which can make infections more serious

Symptoms

• Sore throat and pain or difficulty swallowing
• Red, swollen tonsils, sometimes with white patches
• Fever, headache, tiredness, earache, cough, or feeling sick
• Tender swollen glands in the neck and bad breath

When to see a doctor

Get same-day medical advice if throat pain makes it hard to eat or drink, you have pus-filled spots, symptoms are getting worse, or they have not improved after about a week. Call 999 or go to A&E for rapidly worsening severe throat pain, trouble breathing or swallowing, drooling, difficulty opening the mouth, muffled speech, or swelling in the mouth or throat.

Diagnosis

A clinician usually asks about symptoms and looks at the throat and neck. A throat swab may be used when bacterial infection is suspected. A blood test may be considered if symptoms are severe, prolonged, or glandular fever is possible.

Treatments

Self-care and lifestyle

• Give children only age-appropriate medicines and never give aspirin to anyone under 16
• Check combination cold and flu products to avoid accidentally taking too much paracetamol
• Wash hands, cover coughs and sneezes, and avoid close contact while feverish or too unwell for usual activities
• Seek advice before using medicines if pregnant, taking blood thinners, or if there is a history of stomach ulcers, kidney disease, or asthma

Prevention

Handwashing, covering coughs and sneezes, and not sharing cups or cutlery during an infection can reduce spread. There is no guarantee that tonsillitis can be prevented.