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Tonsillitis in Adults

Tonsillitis is swelling and redness (inflammation) of the tonsils. It happens when the tonsils are infected by a virus or a bacteria. Your tonsils are 2 pink, oval lymph glands at the back of your throat. They are part of your immune system, which helps your body fight infection. They react when germs get inside your nose and mouth.

Tonsillitis is very common. It is most often seen in children, but it can also occur in young adults.

The viruses and bacteria that cause tonsillitis can be easily passed from one person to another.

Front view of face with open mouth comparing oral cavity and tonsils with inflamed throat and enlarged tonsils.

What causes tonsillitis?

Tonsillitis is most often caused by a virus.

Common viruses that cause tonsillitis include:

  • Cold viruses

  • Adenoviruses

  • Epstein-Barr virus

  • Infectious mononucleosis

  • Herpes simplex virus (HSV)

  • Cytomegalovirus

  • Measles

In some cases tonsillitis is caused by a bacteria. Bacterial tonsillitis is often called strep throat. The most common type of bacteria that causes tonsillitis is GABS (Group A beta-hemolytic streptococcus). The bacteria is spread through droplets in the air. This happens when someone with the virus coughs or sneezes. It can also be spread by sharing food or drinks.

Symptoms of tonsillitis

Symptoms will depend on which type of tonsillitis you have. There are several types of tonsillitis.

Acute tonsillitis

Symptoms for this type often go away in a few days. But they can last up to 2 weeks. In some cases symptoms come back after treatment is done (acute recurrent tonsillitis). Symptoms include:

  • Fever

  • Sore throat

  • Bad breath

  • Trouble swallowing

  • Fluid loss (dehydration)

  • Sore lymph nodes in the neck

  • Tiredness

  • Snoring, sleep apnea, or breathing through the mouth

  • White patches, pus, or red tonsils

  • A red rash on the body

Chronic tonsillitis

For this type, the infection or inflammation lasts for a few months. Symptoms include:

  • Lasting sore throat

  • Bad breath

  • Lasting sore lymph nodes in the neck

  • Bacteria and debris collecting on the tonsils (called tonsil stones)

Peritonsillar abscess

This is a severe form of tonsillitis. It occurs when a pocket of pus (an abscess) forms around the tonsil. You need treatment right away. This can help stop the abscess from blocking your airway. Symptoms include:

  • Severe throat pain

  • Trouble opening the mouth

  • Drooling

  • Voice sounds muffled

  • One tonsil may look larger

Diagnosing tonsillitis

If you have symptoms, see your primary healthcare provider. Or see an ear, nose, and throat doctor (ENT or otolaryngologist).

The provider will ask about your symptoms. He or she will also check your ear, nose, and throat for any swelling and infection. The provider will then swab your tonsils or the back of your throat. This sample can be checked in the provider’s office for strep throat. This is called a rapid strep test. Results are ready in a few minutes. But there can be false negatives with this test. So the provider will likely also send the sample out to a lab for testing (throat culture). The lab results will take 24 hours or longer. But a throat culture is more accurate.

Treatment for tonsillitis

Treatment will depend on what is causing the tonsillitis. If it’s caused by bacteria, then your provider may prescribe antibiotics to help you recover. Finish all of the medicine even if you start to feel better.

Tonsillitis caused by a virus can’t be treated with antibiotics. This kind of infection often goes away on its own. Home care may be all that you need, with rest and fluids. Follow these tips to help ease your symptoms at home:

  • Get plenty of rest.

  • Drink lots of fluids, such as soup, broth, and tea with honey and lemon.

  • East soft foods such as ice cream, applesauce, and flavored gelatins.

  • Gargle with warm saltwater.

  • Use over-the-counter throat sprays or lozenges for throat pain.

  • Take over-the-counter medicine for fever and pain, as directed.

  • Use a cool-mist humidifier to keep the air moist.

In severe cases, a person may be dehydrated or have a blocked airway. They may need to be hospitalized.

Surgery to remove the tonsils (tonsillectomy) may be needed if you have any of these:

  • Chronic tonsillitis

  • Tonsillitis that keeps coming back

  • Obstructive sleep apnea

  • Acute recurrent tonsillitis

If you have a peritonsillar abscess, surgery may be done to drain the abscess.

Preventing tonsillitis

Tonsillitis itself can’t spread. But the virus and bacteria that cause it can be passed to other people.

No vaccine or medicine can prevent tonsillitis. These tips can help keep you from spreading or catching an illness that can cause tonsillitis:

  • Stay away from anyone with tonsillitis or a sore throat as much as possible.

  • Don't share utensils, drinking glasses, toothbrushes, or other personal objects with anyone who has tonsillitis or a sore throat.

  • Wash your hands correctly. Wash them often with soap and water often. Use hand sanitizer when you can’t wash your hands.

  • Cover your mouth when you cough or sneeze.

Call 911

Call 911 if you have any of these symptoms:

  • Trouble breathing or speaking

  • Trouble swallowing or opening your mouth

  • Swollen mouth and throat

  • Drooling

When to call your healthcare provider

Call your healthcare provider if you have any of these symptoms:

  • Fever of 100.4°F (38°C) or higher, or as directed by your provider

  • A lump that gets larger

  • Worsening throat pain or neck pain

  • Unable to open your mouth fully (called lockjaw or trismus)

  • Neck stiffness

  • Bleeding

  • Painful swallowing

  • Feeling very ill or sick

  • Sore throat for more than 2 days

Online Medical Reviewer: Daphne Pierce-Smith, RN, MSN, CCRC
Online Medical Reviewer: Raymond Kent Turley, RN, BSN
Date Last Reviewed: 7/1/2019
© 2000-2019 The StayWell Company, LLC. 800 Township Line Road, Yardley, PA 19067. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.
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