What is tonsillitis?

Tonsillitis is inflammation of your tonsils. The tonsils are glands found at both sides of the back of your throat.

Your tonsils are part of your immune system and help protect your body against infection.

Tonsillitis makes your tonsils swollen and sore. It is most common in children. Adults can get tonsillitis, but it is less common.

What are the symptoms of tonsillitis?

Symptoms of tonsillitis include:

• a sore throat
• trouble swallowing
• fever
• swollen lymph nodes (glands) in your neck
• headache
• loss of appetite (not feeling like eating)
• bad breath

You may notice that your tonsils look red and swollen.

What causes tonsillitis?

Tonsillitis is usually caused by viruses, often the same viruses that cause colds and flu.

Glandular fever, usually caused by the Epstein-Barr virus, can cause severe tonsillitis, usually in teenagers.

Tonsillitis can also be caused by bacteria. The most common type of bacteria involved is streptococcus (sometimes called 'strep' throat).

Is tonsillitis contagious?

Tonsillitis itself is not contagious, but the viruses and bacteria that cause tonsillitis can be spread to other people.

To avoid spreading infection, it's important to:

• keep away from people while unwell
• wash your hands often
• avoid sharing eating and drinking utensils with someone who is unwell

If your child has tonsillitis, they should stay at home until their fever has gone and they are able to swallow comfortably again. This will usually take 3 to 4 days.

When should I see my doctor?

If you think your child has tonsillitis for the first time, take them to their doctor. If your child has had tonsillitis before and they usually improve with care at home, you don't always need to see a doctor.

See your doctor if you are worried, or if you or your child has:

• a high fever
• increasing pain even after taking pain-relief medicines
• increasing pain on one side of the throat

How is tonsillitis diagnosed?

To diagnose tonsillitis, your doctor will ask about your symptoms and examine you. They will check for redness or spots on your tonsils and swollen lymph nodes. They might also check your temperature and examine your skin and abdomen.

For people at low risk of rheumatic fever, a throat swab is not usually recommended.

How is tonsillitis treated?

Your treatment will depend on the cause of your tonsillitis and how severe your symptoms are. Most people with tonsillitis can recover at home and will feel better in about a week.

Antibiotics

Most people who have tonsillitis do not need antibiotics.

Your doctor may prescribe antibiotics if you develop complications of tonsillitis, or have a high risk of developing rheumatic fever.

This decision aid can help you work out whether you should take antibiotics.

Pain relief

Paracetamol can help reduce pain, fever or headache. It usually works well for people with tonsillitis.

If you have severe pain that isn't responding to paracetamol, your doctor may prescribe other medicines such as prednisolone.

Self-care measures

General measures to help you or your child recover include:

• getting plenty of rest
• drinking plenty of fluids to prevent dehydration
• gargling with warm salt water to relieve a sore throat — spit the water out afterwards
• eating soft, cool foods (such as ice cream and jelly), which can soothe a sore throat
• sucking throat lozenges

Surgery

If you or your child gets tonsillitis a lot, your doctor may recommend surgery to remove your tonsils. The operation is known as a tonsillectomy.

People who have a tonsillectomy need a general anaesthetic. Some people have the tonsillectomy as day surgery, others stay in hospital overnight.

A tonsillectomy is a very common surgery. However, all surgeries have some risks. You should discuss these with your doctor.

Talk to your doctor about whether a tonsillectomy is likely to help you or your child.

What are the complications of tonsillitis?

Sometimes tonsillitis is caused by a bacterial infection called Group A streptococcus. If left untreated, this kind of infection can cause complications, such as:

• scarlet fever
• rheumatic fever

A middle ear infection is a common complication of tonsillitis.

An uncommon complication of tonsillitis is a peri-tonsillar or neck abscess (collection of pus). This can cause symptoms including:

• very sore throat that may be worse on one side
• fever
• neck pain (especially when moving your neck)
• difficulty opening your mouth
• painful swallowing, trouble swallowing or dribbling
• voice changes or difficulty speaking

Can tonsillitis be prevented?

There is no vaccine against tonsillitis. Having tonsillitis doesn't protect you from getting it again — you can have it more than once.

There are things you can do to help prevent spreading the viruses and bacteria that cause tonsillitis.

Resources and support

To learn more about tonsillitis, see these fact sheets from:

• Safer Care Victoria
• The Royal Children's Hospital
• Agency for Clinical Innovation — Emergency Care Institute

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with you 24 hours a day, 7 days a week.

Languages other than English

Find information in a number of community languages on topics such as fever and pain relief for children.

Information for Aboriginal and/or Torres Strait Islander peoples

This comic for Aboriginal and/or Torres Strait Islander people explains how tonsillitis can lead to complications.

Find an Aboriginal Community Controlled Health Organisation (ACCHO) in your area.