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Tonsillitis

Sore throat - tonsillitis

Tonsillitis is inflammation (swelling) of the tonsils.

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Lymphatic system
Throat anatomy
Strep throat

Causes

The tonsils are lymph nodes in the back of the mouth and top of the throat. They help to filter out bacteria and other germs to prevent infection in the body.

A bacterial or viral infection can cause tonsillitis. Strep throat is a common cause.

The infection may also be seen in other parts of the throat. One such infection is called pharyngitis.

Tonsillitis is very common in children.

Symptoms

Common symptoms may be:

Other problems or symptoms that may occur are:

Exams and Tests

Your health care provider will look in the mouth and throat.

A rapid strep test can be done in most providers' offices. However, this test may be normal, and you can still have strep. Your provider may send the throat swab to a laboratory for a strep culture. Test results can take a few days.

Treatment

Swollen tonsils that are not painful or do not cause other problems do not need to be treated. Your provider may not give you an antibiotic. You may be asked to come back for a checkup later to assess your progress.

If tests show you do have strep, your provider will give you an antibiotic. It is important to finish all of your antibiotic doses as directed, even if you feel better. If you do not take them all, the infection can return.

The following tips may help your throat feel better:

Some people who have repeated infections may need surgery to remove the tonsils (tonsillectomy).

Outlook (Prognosis)

Tonsillitis symptoms due to strep will often get better within 2 or 3 days after you start the antibiotics.

Children with strep throat should be kept home from school or day care until they have been on antibiotics for 24 hours. This helps reduce the spread of illness.

Possible Complications

Complications from strep throat may be severe. They may include:

When to Contact a Medical Professional

Contact your provider if there is:

Related Information

Pharyngitis - sore throat
Common cold
Dehydration
Peritonsillar abscess
Abscess
Rheumatic fever
Acute kidney failure
Poststreptococcal glomerulonephritis (GN)
Tonsil and adenoid removal - discharge

References

Chi DH, Tobey A. Otolaryngology. In: Zitelli BJ, McIntire SC, Nowalk AJ, Garrison J, eds. Zitelli and Davis' Atlas of Pediatric Physical Diagnosis. 8th ed. Philadelphia, PA: Elsevier; 2023:chap 24.

Mitchell RB, Archer SM, Ishman SL, et al. Clinical practice guideline: tonsillectomy in children (update) - executive summary. Otolaryngol Head Neck Surg. 2019;160(2):187-205. PMID: 30921525 pubmed.ncbi.nlm.nih.gov/30921525/#affiliation-3.

Wetmore RF. Tonsils and adenoids. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 411.

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Review Date: 10/31/2022  

Reviewed By: Neil K. Kaneshiro, MD, MHA, Clinical Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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