Tonsillitis: Causes, Symptoms, and Treatment
Wed, April 21, 2021

Tonsillitis: Causes, Symptoms, and Treatment


Tonsillitis refers to the inflammation of the tonsils or the two oval-shaped pads of tissue located at the back of your throat, with one on each side, said Mayo Clinic, an American non-profit academic medical center. In most cases, tonsillitis are caused by a common virus though bacterial infections may also contribute to tonsillitis.

Treatment for tonsillitis depends on the cause. Hence, it is important to consult a professional to obtain a prompt and accurate diagnosis. Although surgery is a once common treatment plan, it is usually done when bacterial tonsillitis occurs frequently as it can cause serious health complications and does not respond to other treatments.

Perceptions of Tonsillectomy Among Patients (2012)

Kishan Ubayasiri and colleagues of Hindawi, an open access research journal and papers, said all patients or parents of young pediatric patients attending the adult and pediatric outpatient ENT departments were instructed to anonymously answer the questionnaires. Only 125 of the 150 questionnaires were returned, consisting of 49 adults and 76 pediatrics. 14% said they themselves were affected by tonsillitis while 24% and 63% answered “their child” and “no one,” respectively. Only 11% said that another family member suffered from tonsillitis and 15% had previously undergone tonsillectomy.  

67% had suffered no tonsillitis, 21% 1-2 bouts, 5% 3-4 bouts, 25 5-6 bouts, and 3% more than seven bouts in the last 12 months. 42% of patients had been prescribed oral antibiotics within the last three years for tonsillitis while only 20% had them on 1-2 occasions. 7% were prescribed oral antibiotics on 2-4 occasions, 2% on 5-6 occasions, and 4% on more than seven occasions. Further, 3% had attended hospital for acute tonsillitis within the last three years and of these, five respondents attended on 1-2 occasions and three attended on 3-4 occasions. Among the eight patients, five were required for admission due to analgesia and intravenous antibiotics. 5% had suffered one previous quinsy while 2% had suffered two or more quinsies.

27% thought tonsillectomy should be offered on patient request, 17% after one to three bouts, and 30% after four to six bouts of tonsillitis. Only 8% of respondents said that the current guideline of seven or more episodes in the previous year reasonable. 14% fulfilled the SIGN guidelines for tonsillectomy after recurrent tonsillitis. Four of the respondents had suffered more than seven bouts of tonsillitis in the last year, four had suffered five episodes of tonsillitis per year for the last two consecutive years, and six had suffered three episodes of tonsillitis per year for the last three consecutive years.  

The Prevalence, Pattern, and Management of Tonsillitis Among Students (2019)

S. Bismi and colleagues of Rubatosis, an academic publisher, said 49 out of 50 participants responded to the questionnaires. According to the authors, 77% of females were affected by tonsillitis compared to 22.9% of men. Tonsillitis worsened among respondents with sore throat (56.8%), ear ache (31.8%), headache (36.4%), stiff neck (6.8%), and scratchy sound voice (40.9%).

Regarding the respondents’ treatment strategy, they resorted to self-medication (13%), home remedies (40%), and consultation with a physician (47%). The most commonly used OTC medicines for tonsillitis were rest (17%), gargle with warm salt water (85.1%), throat lozenges (17%), humidifiers (17%). Approximately 62.2% of respondents used antibiotics and of those, they used amoxicillin-clavulanic acid (61.5%).   



Causes of Tonsillitis

The most common bacterium is Streptococcus pyogenes (group A streptococcus), which causes strep throat. However, other strains of strep and other bacteria may also lead to tonsillitis. Tonsils are your immune system’s first line of defense against bacteria and viruses that enter your mouth. Children ages five to 15 are more vulnerable to tonsillitis and viral tonsillitis is more prevalent in younger children. Moreover, close contact with peers and frequent exposure to viruses or bacteria may also increase children’s risk of developing tonsillitis.

Unfortunately, guarding against viruses and bacteria make the tonsils more at risk of inflammation and infection. After puberty, the tonsil’s immune system function diminishes, which may be correlated to the rare cases of tonsillitis among adults. Julie Marks of Healthline, a medical and health news website, said tonsils play a smaller role in your immune system after puberty, which explains why tonsillitis might affect more kids and teens.

Symptoms and Diagnosis of Tonsillitis

Symptoms of this condition in adults are similar to those of children. Common signs of tonsillitis include sore throat, pain when swallowing, earache, stiff neck, fever, bad breath, scratchy neck, white or yellow patches on the tonsils, enlarged lymph nodes in the neck, and more.  

On the other hand, sever symptoms of tonsillitis are swollen, painful glands in your neck and white pus-filled spots on your tonsils, noted the NHS (National Health Service), the UK’s healthcare system. Signs of tonsillitis usually disappear after three to four days. When diagnosing tonsillitis, your doctor can ask about your symptoms and look at the back of your throat by wiping a cotton bud to test for bacteria. They can also perform a blood test to see if you have glandular fever if your symptoms are not going away or are severe.   



Treatment for Tonsillitis

You can help reduce symptoms of tonsillitis by drinking enough water, gargling a saltwater solution, using a humidifier, taking pain-relieving medication, and sucking on throat lozenges. If you have trouble breathing due to swollen tonsils, your doctor may prescribe you a steroid medication. They may prescribe you with penicillin if you have bacterial tonsillitis. Abscess may develop if left untreated, which happens when pus is collected in a pocket in the back of your throat. In this case, your doctor may drain and cut the abscess or drain it with a needle or they may perform tonsil removal surgery.

Tonsillectomy is recommended for severe or frequent bouts of tonsillitis. It is performed the same way in kids and adults, but for older patients, recovery may take longer. Children may need about seven days to recover while adults may take two weeks to recover. Kids may also be less likely than adults to experience complications like bleeding or significant pain after the procedure. You can discuss with your doctor about the advantages of disadvantages of tonsil surgery if you suffer from chronic or recurrent sore throats involving your tonsils.


Tonsils commonly affect children, but adults can also suffer from this condition. Symptoms range from scratchy neck to painful glands in your neck. It is possible to treat tonsillitis at home, though doctors may prescribe medications. Consult your doctor if you experience repetitive bouts of tonsillitis or if you have severe symptoms.