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Tonsillitis
Tonsillitis is inflammation of the tonsils, usually as a result of an infection by either a virus or bacteria.
About tonsillitis
Symptoms of tonsillitis
Complications of tonsillitis
Causes of tonsillitis
Diagnosis of tonsillitis
Treatment of tonsillitis
About tonsillitis
The tonsils
Your tonsils are small lumps of tissue that lie at the back of your throat, one on each side. They help your body fight infection when you’re young. They are less involved with fighting infection as you get older.
The position of the tonsils
What is tonsillitis?
Tonsillitis means inflammation of your tonsils. It affects people of all ages but it's more common in children.
Symptoms of tonsillitis
Symptoms of tonsillitis include:
- sore throat
- difficulty swallowing
- tiredness
- high temperature
- bad breath
- earache
- headache
You may also notice that:
- you have red and swollen tonsils
- the back of your throat is red
- there are white spots on your tonsils (this is pus from the infection)
- the glands in your neck are bigger than usual
If your tonsils are inflamed they can block your airways, making it difficult for you to breathe, especially when you’re asleep. This can cause sleeping problems. Sometimes your inflamed tonsils can stop you from breathing for a short time – this is called sleep apnoea.
Complications of tonsillitis
Tonsillitis can sometimes lead to complications, including:
- middle ear infections
- an abscess on or around your tonsils – this is called a quinsy
- problems with breathing - if your tonsils are so big that that they restrict your airways, or you have a quinsy
- inflammation of your sinuses (sinusitis)
- a lung infection, such as bronchitis or pneumonia
- inflammation of your kidneys (acute glomerulonephritis)
- a fever with painful, swollen or stiff joints (rheumatic fever)
- a rash, which may develop if you have a group A beta haemolytic Streptococcus bacterial infection (scarlet fever)
- infection of your blood (septicaemia)
Causes of tonsillitis
There are many viruses and bacteria that cause tonsillitis. These include the influenza (flu) virus, the Epstein-Barr virus (that causes glandular fever) and group A beta haemolytic Streptococcus bacteria.
The infection can be passed between people. If you’re in close contact with an infected person, if you kiss them for example, or you’re near them when they cough or sneeze, you can breathe in droplets of infected mucus or saliva and get the infection yourself. There is also a risk of you catching it if you share a toothbrush or eating utensils with an infected person.
Diagnosis of tonsillitis
Your doctor will ask about your symptoms and examine you. He or she may also ask you about your medical history. Your doctor will usually make a diagnosis based on this information alone.
Sometimes you may need to have a throat swab test. A throat swab is similar to a small round cotton bud and it’s used to take a small sample of mucus from your tonsils. This will be sent to a laboratory for testing to determine what type of infection you have.
You may be asked to have a blood test to see whether you have glandular fever.
Treatment of tonsillitis
Self-help
If your infection is mild, you may not need treatment. There are several things you can do to help yourself feel better.
- Rest in a quiet, warm place and try to sleep.
- Ensure you drink enough fluids, as dehydration can make you feel worse.
- Gargle with salt water - this may ease the pain in your throat.
There are a number of over-the-counter medicines that may help to relieve the pain, including:
- paracetamol – particularly if you hold soluble paracetamol in your mouth
- non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen
- gargling with soluble aspirin (aspirin isn’t suitable for children under 16)
Always read the patient information leaflet that comes with your medicine and if you have any questions, ask your pharmacist for advice.
Medicines
If your tonsillitis is caused by a bacterial infection, your doctor may prescribe a course of antibiotics. If your doctor does suggest that you take antibiotics, you will probably be prescribed a 10 day course. It's important to complete the full course prescribed to you.
Always ask your doctor for advice and read the patient information leaflet that comes with your medicine.
Antibiotics can only be used to treat bacterial infections so your doctor won’t prescribe them if you have tonsillitis caused by a virus.
Surgery
If you have tonsillitis more than five times a year or it stops you doing your usual activities, your doctor may refer you to an ENT surgeon (a doctor who specialises in the surgical and medical treatment of conditions of the ear, nose and throat) for surgery to remove your tonsils. This operation is called a tonsillectomy.
Before you choose this treatment it’s important to discuss it with your surgeon to make sure that you understand the risks, benefits and possible alternatives to the procedure. As young children get older, tonsillitis becomes less common, so an operation isn’t always necessary.
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This section contains answers to common questions about this topic. Questions have been suggested by health professionals, website feedback and requests via email. See our answers to common questions about tonsillitis, including:
I have a sore throat, should I contact my doctor?
My child has had lots of time off school due to tonsillitis – should she have her tonsils removed?
How long does tonsillitis last for?
I have a sore throat, should I contact my doctor?
You can usually treat your sore throat at home. But contact your doctor if it's particularly severe or if it doesn't improve after several days.
Explanation
It's common to develop several sore throats a year. These aren't always due to tonsillitis. They usually clear up within a week without the need for medical treatment.
If your sore throat is mild, you can usually treat it at home. Take paracetamol or ibuprofen for the pain, make sure you drink enough and try gargling with warm salty water. Always read the patient information leaflet that comes with your medicine and if you have any questions, ask your pharmacist for advice.
Contact your doctor if your sore throat hasn't improved after several days, or if you have:
- any difficulty breathing
- any difficulty swallowing saliva or opening your mouth
- a persistent high temperature
- a severe sore throat, particularly with symptoms mainly on one side of your throat
Sore throats can occasionally be a sign of a more serious condition. If you're concerned, discuss this with your doctor. He or she will be able to give you advice on any tests or treatment that you might need.
My daughter has had lots of time off school due to tonsillitis – should she have her tonsils removed?
If your daughter has missed a lot of school and the condition is clearly interfering with her everyday life, you may wish to consider having her tonsils removed in a procedure called a tonsillectomy. However, as children get older, problems with their tonsils are less common so an operation isn’t always necessary.
Explanation
A child’s tonsils are usually only taken out if they are causing him or her to have regular sore throats, despite treatment with antibiotics. If your daughter has been diagnosed with tonsillitis more than five times in a year or tonsillitis stops her from doing her normal activities, your GP may refer your daughter to an ENT surgeon (a doctor who specialises in the surgical and medical treatment of conditions of the ear, nose and throat) for surgery to remove her tonsils.
Usually, the number of sore throats a child gets decreases as they get older and their tonsils shrink in size, so having a tonsillectomy may not be necessary. By the time your daughter has the operation, she may have already grown out of it, especially if there is a long wait before surgery. It may be better to wait and see if the problem with her tonsils gets better on its own before considering the operation.
If your daughter’s ENT surgeon does think that surgery is necessary, he or she will explain to you why it's the best treatment for your daughter. Most people who have a tonsillectomy find that they benefit from the operation. However, having your daughter’s tonsils removed is no guarantee that she won't have any sore throats in the future.
Having a tonsillectomy is generally very safe but any type of surgery carries a risk. Discuss the risks and benefits of the operation with your daughter’s surgeon.
How long does tonsillitis last for?
Most people recover from tonsillitis after a week or less.
Explanation
For the majority of people, the symptoms of tonsillitis have gone within one week. However, you can recover from tonsillitis a lot quicker than this. In four out of ten people, the symptoms only last for three days. If your sore throat doesn't improve after several days, contact your doctor for advice.
Further information
ENT UK
020 7404 8373
www.entuk.org
Sources
- Tonsil surgery. ENT UK. www.entuk.org, accessed 29 October 2009
- Burton MJ, Glasziou PP. Tonsillectomy or adeno-tonsillectomy versus non-surgical treatment for chronic/recurrent acute tonsillitis. Cochrane Database of Systematic Reviews 2009, Issue 1. doi: 10.1002/14651858.CD001802.pub2.
- Recurrent throat infections (tonsillitis). BMJ Clinical Evidence. www.clinicalevidence.bmj.com, accessed 29 October 2009
- Acute tonsillitis: clinical features. GP Notebook. www.gpnotebook.co.uk, accessed 23 November 2009
- Sore throat - acute. Clinical Knowledge Summaries. www.cks.nhs.uk, accessed 23 November 2009
- Respiratory tract infections - antibiotic prescribing. National Institute for Health and Clinical Excellence (NICE), July 2008, www.nice.org.uk
- Sore throat - acute. Clinical Knowledge Summaries. www.cks.nhs.uk, accessed 15 December 2009
- Aspirin. British National Formulary. www.bnf.org, accessed 23 November 2009
- Advice to patients - tonsillitis and sore throat. Scottish Intercollegiate Guidelines Network (SIGN), 1999. www.sign.ac.uk
- Recurrent acute tonsillitis. GP Notebook. www.gpnotebook.co.uk, accessed 23 November 2009
This information was published by Bupa’s Health Information Team and is based on reputable sources of medical evidence. It has been peer reviewed by Bupa doctors. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional.
Publication date: March 2010.
Related topics
Acute sinusitis
Antibiotics
Middle ear infection in children
Non-steroidal anti-inflammatory drugs (NSAIDs)
Paracetamol
Pharyngitis
Tonsillectomy in children
Related topics
Acute sinusitis
Adenotonsillectomy in children
Antibiotics
Chronic obstructive pulmonary disease (COPD)
Chronic sinusitis
Glandular fever
Meningitis and septicaemia in adults
Meningitis and septicaemia in children
Middle ear infection in children
Non-steroidal anti-inflammatory drugs (NSAIDs)
Paracetamol
Pneumonia
Scarlet fever
Seasonal flu
Sinusitis in children
Sleep apnoea
Tonsillectomy in children
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