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Tonsillitis
Reviewed by Medicinsk Expert•Last updated: 2026-10-22•Mouth Teeth

Tonsillitis

Tonsillitis is an inflammation of the tonsils, usually caused by a viral or bacterial infection, which often requires rest and proper medical management.

What are tonsils?

Tonsils are two lumps of tissue located at the back of the throat, one on each side. As part of the lymphatic system, they work alongside the adenoids to clear away infection and keep body fluids in balance by trapping germs that enter through the mouth and nose.

What is tonsillitis?

Tonsillitis is an inflammation (swelling) of the tonsils. In some cases, the adenoids may also become swollen.

Causes and Risk Factors

Tonsillitis is usually caused by a viral infection, though bacterial infections like strep throat can also be the cause. It is most common in children over age two. While almost every child in the U.S. experiences it at least once, bacterial tonsillitis is more common in children ages 5–15, whereas viral tonsillitis is more common in younger children. Adults can get tonsillitis, though it is less common.

While tonsillitis itself is not contagious, the viruses and bacteria that cause it are. Frequent handwashing is recommended to prevent the spread of these infections.

Symptoms

Symptoms include:

  • A sore throat, which may be severe
  • Red, swollen tonsils
  • Trouble swallowing
  • A white or yellow coating on the tonsils
  • Swollen glands in the neck
  • Fever
  • Bad breath

When to See a Doctor

Contact your health care provider if your child:

  • Has a sore throat for more than two days
  • Experiences trouble or pain when swallowing
  • Feels very sick or weak

Seek emergency care immediately if your child:

  • Has trouble breathing
  • Starts drooling
  • Has significant difficulty swallowing

Diagnosis

A provider will review symptoms and medical history, and examine the throat and neck for redness, white spots, or swollen lymph nodes. To check for strep throat, they may perform a rapid strep test (results in minutes) or a throat culture (lab-processed, takes a few days). Because the throat culture is more reliable, a provider may order one even if a rapid test is negative.

Treatment and Management

Treatment depends on the cause. Viral tonsillitis has no specific medicine, while bacterial infections require antibiotics. It is essential to finish the entire course of antibiotics to prevent bacteria from surviving and re-infecting the child.

To help your child feel better:

  • Ensure they get plenty of rest and fluids.
  • Offer soft foods, warm liquids, or cold foods like popsicles.
  • Avoid cigarette smoke or other throat irritants.
  • Use a humidifier in their room.
  • Have them gargle with saltwater.
  • Use lozenges (only for children over four to avoid choking).
  • Use over-the-counter pain relievers like acetaminophen (do not give aspirin to children or teenagers).

Tonsillectomy

A tonsillectomy is the surgical removal of the tonsils. It may be recommended if a child experiences recurrent tonsillitis, bacterial tonsillitis that does not respond to antibiotics, or if the tonsils are so large they cause breathing or swallowing difficulties. Most children go home the same day as the surgery, though recovery typically takes one to two weeks.

Frequently Asked Questions

To prevent spread, emphasize frequent and thorough handwashing for everyone, especially after coughing, sneezing, or touching the face. Avoid sharing eating utensils, cups, and food. To reduce recurrence, ensure your child completes any prescribed antibiotic courses, maintains good hygiene, and avoids close contact with sick individuals when possible.
tonsillectomy is usually considered for recurrent tonsillitis, often defined as seven episodes in one year, five episodes per year for two consecutive years, or three episodes per year for three consecutive years. It may also be recommended if tonsillitis causes significant breathing problems during sleep (sleep apnea), difficulty swallowing, or if antibiotics are ineffective for chronic bacterial infections.
It's often difficult to tell the difference based on symptoms alone, as both can cause a sore throat, fever, and swollen tonsils. However, bacterial tonsillitis (like strep throat) often presents with a more sudden onset, absence of cough, and sometimes a rash. It matters because bacterial infections require antibiotics, while viral infections do not and are managed with supportive care. A doctor can perform a rapid strep test or throat culture to confirm.
To relieve discomfort, ensure your child gets plenty of rest and drinks lots of fluids to prevent dehydration. Offer soft, easy-to-swallow foods. Over-the-counter pain relievers like acetaminophen or ibuprofen (check age-appropriate dosing) can help with pain and fever. Gargling with warm salt water (for older children) and using throat lozenges or sprays can also provide temporary relief.
Source: MedlinePlus, National Library of Medicine

MedlinePlus brings together authoritative health information from the National Library of Medicine (NLM), the National Institutes of Health (NIH), and other government agencies and health-related organizations.

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