Tonsillitis is inflammation of the tonsils, two areas of tissue at the back of the throat. It commonly causes a sore throat and painful swallowing and may occur with fever, swollen neck glands, headache, or white patches. Viruses cause many cases, although bacteria such as group A streptococcus can also be responsible.
Why the cause matters
Throat redness or white patches do not reliably distinguish a viral illness from a bacterial one. Clinicians consider age, duration, cough, fever, lymph nodes, exposure history, and the examination. A throat swab or other test may be recommended when it would change management. Antibiotics do not treat viral tonsillitis and should be used only when a clinician determines they are indicated.
Most uncomplicated cases improve over several days. Rest, fluids, and suitable pain relief may help; medicine choice depends on age, pregnancy, other health conditions, and current medicines. Avoid giving aspirin to children unless a specialist has specifically directed it.
Self-care and reducing spread
Choose cool or warm fluids according to comfort, rest, and avoid smoking or second-hand smoke. Good hand hygiene and covering coughs can reduce spread of the viruses and bacteria that cause many throat infections. Do not share drinking bottles or utensils while acutely unwell.
If antibiotics are prescribed, follow the instructions and ask what to do if a dose is missed or side effects occur. Do not use leftover antibiotics from a previous illness, because the drug or duration may be wrong and unnecessary antibiotics can cause harm.
When to seek care
Arrange a review if symptoms do not improve within about a week, infections recur, or pain makes it difficult to eat and drink. A clinician may consider other causes, including glandular fever or a complication around the tonsil.
Seek emergency care for difficulty breathing, inability to swallow saliva, drooling, rapidly worsening severe throat pain, a muffled voice with swelling, or difficulty opening the mouth. These may be signs of a serious complication such as a peritonsillar abscess.
Common questions
Do white patches always mean antibiotics are needed? No. White patches may occur with different infections; testing and the whole clinical picture guide treatment.
When is tonsil surgery considered? It may be discussed for selected people with severe recurrent infections or specific complications, after weighing benefits, recovery, and risks.
Explore our tonsillectomy page for more information about this care option. A clinician can advise based on the individual history and examination findings.