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Tonsillitis can usually be treated at home and very rarely requires a tonsillectomy (removal of tonsils).
The infection is more common in toddlers and children but you can still get tonsillitis as an adult.
Find out whether you have viral or bacterial tonsillitis and get the right treatment today.
Tonsils are the two balls of tissue located at the back of your throat. They function as part of the lymphatic system which helps protect you from infections. Tonsillitis is inflammation of the tonsils caused by a viral or bacterial infection. Symptoms may include a sore throat, swollen tonsils and fever.
The infections that cause tonsillitis are contagious. The contagious period will depend on the type of infection (viral or bacterial) and treatment. Tonsillitis is spread when an infected person talks, coughs or sneezes. Keep contact with infected persons to a minimum to reduce the risk of catching tonsillitis.
Mild tonsillitis can be difficult to self-diagnose because symptoms may feel similar to having a cold or the flu, including a sore throat, high temperature, headache and cough. Adults tend to have 2-3 infections of the common cold every year but plenty of rest and water should help you recover in 1 to 2 weeks.
Learning the common signs of tonsillitis can help you get rid of the infection faster with more effective treatment. We can help with:
What are the signs of tonsillitis? And what does tonsillitis feel like?
Tonsillitis symptoms include:
If you notice any of these signs of tonsillitis, speak with your pharmacist who will be able to offer you treatment and advice. If these symptoms of tonsillitis persist, you should visit your GP.
In more severe cases of tonsillitis, you might also experience:
If you are experiencing these more severe symptoms, you should speak with your GP who will be able to offer you advice and treatment for your tonsillitis.
The tonsillitis incubation period is 2 to 4 days. This means symptoms start to appear 2 to 4 days after catching the infection. During this period, you can still pass on tonsillitis to others despite not displaying any symptoms of inflamed tonsils.
Tonsillitis can feel different depending on whether it is caused by a viral or bacterial infection. Symptoms are often milder when they are caused by a virus. Bacterial tonsillitis symptoms can be more severe and may be accompanied by bad breath.
Read Chapter 2 to find out about the differences between bacterial tonsillitis symptoms and viral tonsillitis symptoms.
When you have tonsillitis, your tonsils will often appear red, enlarged and swollen, with redness of the throat. If you have a more severe tonsillitis caused by a bacterial infection, you might also notice whitish pus-filled spots on your tonsils, a swollen uvula and a grey furry tongue.
For pictures of tonsillitis, see Chapter 10.
Complications of tonsillitis mostly affect children aged 2 to 4. However, it is very rare for complications of tonsillitis to occur. Quinsy is a result of a pocket filled with pus, also known as an abscess, forming between your tonsils and the wall of your throat.
Symptoms of quinsy:
It is important to see a GP urgently or visit A&E if you believe you might have quinsy tonsils.
It is important to know if your tonsillitis is the result of a bacterial infection or a viral infection. This will determine how severe your symptoms are, what your tonsillitis looks like and which course of treatment you should take.
There are some telltale signs to look out for. A GP will be able to examine you and identify the type of tonsillitis you have to give you the best treatment possible. We can help with:
Are tonsils needed? And what is the difference between viral and bacterial tonsillitis?
When you catch an infection, your tonsils help your body to fight off that infection. As part of your immune system, they work similarly to how your lymph nodes (glands in your neck) work, as the first line of defence against infection. As your tonsils fight infection, they usually become red and start to swell, causing your throat to become sore.
Most tonsillitis infections are viral, usually resulting from the common cold or flu. The symptoms of viral tonsillitis are usually milder than its bacterial counterpart and cannot be treated with antibiotics.
Up to one in three cases of tonsillitis are a result of a bacterial infection. Bacterial tonsillitis usually has more severe symptoms than viral tonsillitis and can be accompanied by bad breath. Children are the most likely to get bacterial tonsillitis.
There a few important differences between viral and bacterial tonsillitis, including:
Diagram of bacterial and viral tonsillitis:
While tonsillitis can often be treated at home, there are some cases where you will need to see a GP:
In most cases, treatment for tonsillitis is not necessary as it often goes away on its own. However, more severe tonsillitis requires treatment to help you get better again quickly.
There a variety of different treatment options for tonsillitis, including at-home care, over-the-counter medicines, prescription antibiotics, and even surgery. We can help with:
What is the best treatment for tonsillitis? And what is tonsillectomy?
Acute tonsillitis can often be treated at home:
If your tonsillitis is caused by a bacterial infection, your doctor might prescribe you with a course of antibiotics to help fight the infection. In most cases, you will be prescribed with a 10-day course of penicillin or amoxicillin to help fight bacterial tonsillitis infections. If you are allergic to penicillin, there are alternative medicines that your GP can prescribe.
It is important to complete the entire course of antibiotics, even if your symptoms have gone before your course is finished. If you fail to complete a full course of antibiotics, you risk the infection worsening and spreading to other parts of the body. This can increase your risk of developing serious kidney inflammation and rheumatic fever.
Your doctor will use the centor criteria to decide whether to prescribe antibiotics or adopt a ‘watch and wait’ approach. The suggested management depends on your score:
Centor criteria table:
| Criteria | Points | |------------------------ |-------- | | Temperature >38°C | 1 | | Absence of a cough | 1 | | Swollen glands | 1 | | Tonsil swelling or pus | 1 | | Age | | | 3-14 years old | 1 | | 14-44 years old | 0 | | 45+ years old | -1 |
Tonsillectomy is a surgery which involves removing your tonsils. This is a rare procedure and is only necessary in cases of severe tonsillitis that keeps coming back.
Although tonsillectomy can be a cure for tonsillitis, you can still get infections or a sore throat after your tonsils have been removed. However, having your tonsils removed has been shown to be effective at getting rid sore throats for many patients.
In most cases, tonsillitis can be treated by a GP and does not require your tonsils to be removed. If you think you need a tonsillectomy, speak with your doctor to see if you meet the criteria.
During a tonsillectomy surgery, most of your tonsil tissue is removed. However, some tissue might remain which can result in tonsils occasionally regenerating. Despite this, it is unlikely for your tonsils to ever fully grow back to their original size after having them surgically removed. The younger you are when your tonsils are removed, the more likely it is that they will grow back.
During your appointment, your GP will ask about your symptoms and examine the back of your throat. This will help them to determine the cause of your tonsillitis and provide you with the best treatment plan.
In some cases, your GP might swab the back of your throat with a cotton bud to test for bacteria. If you have severe tonsillitis, your GP might also refer you to have a blood test to determine whether or not you have glandular fever.
In most cases, tonsillitis can be treated at home with natural remedies and over-the-counter medicine from your pharmacist. These natural remedies can be used to help soothe your sore throat.
If you smoke or are around people who do smoke, simply reducing your exposure to cigarette smoke can help to speed up your recovery for tonsillitis. We can help with:
How to soothe tonsillitis? And how to treat tonsillitis naturally?
Gargling warm salt water and rinsing your mouth with warm salt water can help to soothe your sore throat. It is important to note that this is not suitable for small children. Watch this video on how to gargle warm salt water:
It can often be difficult to eat with tonsillitis as many foods can irritate your throat. The best foods to eat with tonsillitis are:
Natural remedies for tonsillitis include:
If you are struggling to relieve your tonsillitis symptoms using these methods, you might need to see a doctor for treatment. Bacterial infections such as strep throat will require antibiotics and natural remedies for tonsillitis might not work. Speak with your GP who will be able to suggest the best treatment for your tonsillitis.
Ultra chloraseptic anaesthetic throat spray can be used to help relieve the symptoms of a sore throat caused by tonsillitis. It contains the active ingredient benzocaine, a local anaesthetic. When sprayed at the back of your throat, it quickly numbs the pain of a sore throat caused by tonsillitis.
⚠ You should not use this spray if:
How to use throat spray for tonsillitis:
Ultra chloraseptic anaesthetic throat spray can be purchased from your local pharmacy. It is worth noting that there is little evidence to suggest that non-medicated throat sprays help with tonsillitis symptoms. If you experience any side effects while using a throat spray, talk to your GP or pharmacist.
A 2017 study published in the International Archives of Otorhinolaryngology found that smokers may encounter more chronic or recurrent tonsillitis episodes than non-smokers. It was also found that smokers were significantly more likely to experience bleeding tonsils after undergoing tonsillectomy surgery. The authors concluded that quitting smoking might help to reduce episodes of tonsillitis and post tonsillectomy bleeding.
Researchers have also found that children of parents who smoke have an increased chance of acquiring tonsillitis (2014 study published in the European Journal of Pediatrics).
It is worth noting that quitting smoking comes with many health benefits. The following resources can be used to help you quit smoking:
If you are struggling to quit smoking on your own, speak to your GP or pharmacist who will be able to offer you support.
In most cases, tonsillitis will go away on its own without any treatment in just a few days. However, this varies significantly if your tonsillitis was caused by a viral or bacterial infection.
If you have more severe tonsillitis, a visit to your GP might be necessary to help fight the infection and speed up your recovery time. We can help with:
How long does tonsillitis last? And how long is it contagious for?
In most cases, tonsillitis will clear up within 7 to 10 days. However, tonsillitis can be resolved in as little as 3 days. If after 3 or 4 days your tonsillitis does not start to improve, speak with a GP who will be able to examine your tonsillitis and assess the best course of action for you.
Bacterial tonsillitis symptoms can disappear within 24 hours and the infection can clear within 5 to 7 days after taking antibiotic treatment from your GP. Even if your tonsillitis symptoms disappear before your antibiotic course has ended, it is important to take the full course to prevent the infection from worsening and spreading to other parts of your body. Without treatment, bacterial tonsillitis will usually persist for 10 to 14 days.
Tonsillitis is contagious for about 7 to 10 days if the infection was viral and up to 2 weeks for untreated bacterial infections. During this tonsillitis contagious period, others might become infected. It is the infections that cause tonsillitis that is contagious, not tonsillitis itself.
Recurrent tonsillitis is when you have tonsillitis that keeps coming back. This is generally defined as:
If you have recurrent tonsillitis, your GP might suggest that you undergo tonsillectomy surgery as a last resort to reduce your chances of tonsillitis coming back. To learn more about tonsillectomy, see Chapter 3.
Chronic tonsillitis is when you have tonsillitis for an extended period of time (when symptoms have persisted for longer than 2 weeks). If you have chronic tonsillitis, speak to your GP as you might require antibiotics to help clear the infection. As a last resort, your GP might recommend having your tonsils surgically removed.
Tonsillitis can be caused by either a viral infection like the common cold or flu or a bacterial infection. By understanding what causes your tonsillitis, you can better understand how to treat it.
Tonsillitis is a common childhood illness that is difficult to prevent. However, there are some things that you can do to reduce your chances of the illness spreading. Learn about:
How do you catch tonsillitis? And how can you prevent getting tonsillitis?
Tonsillitis itself is not contagious but the infections which cause it are. Tonsillitis causes differ depending on whether the infection is viral or bacterial. Being in close proximity to someone with an active infection is usually what causes tonsillitis.
You can reduce your chances of getting tonsillitis by carrying out strict hygiene practices and staying clear of people who are infected by tonsillitis. If you already have tonsillitis, try to stay away from others until your infection clears up to lessen the chances of it spreading.
Children who have not undergone tonsillectomy are the most susceptible to tonsillitis. The condition is rare in adults as the function of the tonsils in the immune system as the first line of defence against infection declines after puberty. However, it is still possible for people of all ages to have tonsillitis.
Tonsillitis infections are highly contagious and can be caught by kissing or coming into close contact with an infected person. Symptoms of tonsillitis might not show for up to 48 hours after being infected.
When you undergo tonsillectomy, some tonsil tissue can remain and regenerate over time. Therefore, it is still possible to get tonsillitis after having your tonsils removed. However, tonsillectomy has been shown to significantly reduce your chances of getting tonsillitis. To learn more about tonsillectomy, see Chapter 3.
While not all cases of tonsillitis can be prevented, you can reduce your chances of getting tonsillitis by practicing good hygiene. This involves frequently washing your hands with warm, soapy water to help prevent the spread of infection. When you don’t have access to water, alcohol-based sanitisers can help to kill bacteria on your hands. You should also take measures to disinfect the surfaces in your home.
Keeping fit and healthy can help to improve your immune system which gives you a better defence against infections that cause tonsillitis.
It is natural to worry about your child when they have tonsillitis. However, it’s important to remember that this is a common childhood illness and, in most cases, it will pass within a few days.
There are some things that you can do to make your child more comfortable when they are suffering from tonsillitis. We can help with:
How to treat tonsillitis in children? And when should you take your child to see a GP?
Tonsillitis symptoms include:
Some signs that could indicate tonsillitis are:
If you notice any of these signs of tonsillitis, speak with your pharmacist who will be able to offer you treatment and advice for your child. If symptoms persist, you should take your child to see a GP.
Tonsillitis can usually be treated at home. Here are some ways to make your child more comfortable:
The symptoms of tonsillitis will usually clear up within 3 to 4 days, depending on the type of infection which caused it. If your child has more severe bacterial tonsillitis, you might need to take them to see a GP for a course of antibiotics to help fight the infection and speed up recovery.
Remember that tonsillitis is a very common childhood illness. If symptoms do persist or tonsillitis keeps reoccurring, take your child to see a GP. Your doctor might be able to help by prescribing antibiotics for tonsillitis caused by bacterial infections.
It can be difficult to prevent your child from getting tonsillitis. However, you can reduce the chances of your child getting tonsillitis by making sure they wash their hands with warm soapy water and carry out best hygiene practices.
To reduce the chances of tonsillitis spreading around the home, keep surfaces disinfected. Tonsillectomy is not recommended as a way of preventing tonsillitis and is only carried out as a last resort for children suffering from recurrent tonsillitis.
It can be upsetting for parents when their babies have tonsillitis. However, tonsillitis in babies is actually very common and will usually go away on its own within a few days.
It is often difficult to tell if your baby has tonsillitis because they cannot communicate their symptoms with you. There are some signs that parents can look out for that might indicate that your baby is suffering from a tonsillitis infection. We can help with:
What are the signs that your baby has tonsillitis? And when should you see a GP?
Mild cases of tonsillitis will not require treatment. Instead, a ‘watchful waiting’ approach is recommended as your baby recovers naturally while ensuring they get proper nutrition and plenty of rest. For cases of bacterial tonsillitis, your baby will need antibiotics from your GP to help fight the infection. In rare cases, your GP might recommend tonsillectomy to help deal with severe and recurrent tonsillitis.
It can be difficult to tell whether a baby has tonsillitis when they cannot describe how they are feeling. There are some signs that you can look out for to tell if your baby has tonsillitis:
Tonsillitis in babies will usually go away on its own within 3 or 4 days. If symptoms persist for longer than this, you might need antibiotics from your GP to treat a bacterial infection causing your baby’s tonsillitis.
It is natural for parents to worry about their babies while they have tonsillitis. However, it is important to remember that tonsillitis is a common childhood illness that will usually go away on its own within a few days. If symptoms are not showing signs of improvement within this time, antibiotics from your GP might help to speed up your baby’s tonsillitis recovery.
It can be difficult to prevent tonsillitis as it can be very common in babies. However, there are some things that you can do to reduce the chances of your baby catching tonsillitis:
If you are worried about having tonsillitis while pregnant, rest assured that you are not alone. Tonsillitis can be a pain for anyone but pregnant mothers could do without additional struggles that come with tonsillitis.
There is no association between tonsillitis and pregnancy, but you might slightly more susceptible to infection while pregnant than otherwise. We can help with:
How to treat tonsillitis while pregnant? And when should you see a GP?
In most cases, you will be able to treat a tonsillitis infection when pregnant at home. See chapters 3 and 4 to find out more about how tonsillitis can be treated.
If you find that your symptoms are not getting any better after a few days, speak to a GP who will be able to examine you and prescribe a course of appropriate antibiotics for pregnancy if you have tonsillitis that was caused by a bacterial infection.
Paracetamol is a safe and effective way of reducing the pain associated with tonsillitis while pregnant. If you are suffering from tonsillitis caused by a bacterial infection, see your GP can prescribe you with antibiotics that are suitable for pregnancy to help fight the infection.
In most cases, it is not dangerous to have tonsillitis while pregnant. Symptoms will usually clear within 3 to 4 days for viral infections. If you have tonsillitis caused by a bacterial infection like strep throat, your GP will be able to treat the infection with a course of antibiotics.
While searching the internet, it can be easy to mix up strep throat with Group B streptococcus which is a completely unrelated bacteria found in the vagina and anus which can be passed on to your baby during delivery.
If your symptoms have not improved within a few days, consult your GP who will be able to examine you and provide you with the best course of action to treat your tonsillitis.
Tonsillitis can be difficult to prevent, especially as you are slightly more prone to infection while pregnant, but there are some things you can do to reduce your chances of a tonsillitis infection while pregnant:
The following pictures show what tonsillitis can look like.
It is recommended that you see a GP who will be able to accurately diagnose your tonsillitis instead of attempting to diagnose yourself. We can help with:
What does tonsillitis look like?
These tonsils are healthy.
The two tonsils are enlarged, swollen and reddened which is a sign of active tonsillitis.
This shows that both tonsils are swollen and reddened. The whitish/yellowish exudate shows that there is an active infection. This kind of exudate can be a sign of bacterial tonsillitis.
This shows a right sided peritonsillar abscess which is a collection of pus which accumulates at one side of the throat around the tonsil. This can become pretty serious and it is imperative that you see a medical professional if you think you have this.
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