Signs and Symptoms of Tonsillitis

Medically reviewed by Jonathan B. Jassey, DO

Tonsillitis is the inflammation of the tonsils, which are the two lumps of flesh that are located at the back of your throat. Symptoms of the condition usually set on very quickly, causing a sore throat, red and swollen tonsils, and fever, among other symptoms. Tonsillitis most often affects children older than the age of two years old and teenagers. It's important to note that adults rarely develop the condition.

Most people with tonsillitis have acute (short-term) symptoms that resolve either on their own or with treatment. However, some people may have recurrent tonsillitis (symptoms return at least five times over a year) or chronic tonsillitis (symptoms that last longer than three months). That said, knowing the symptoms of the condition can help you identify which type of tonsillitis you or your child has and understand when to get medical support.

Common Symptoms

Generally, the symptoms of tonsillitis tend to go away within three to four days. Acute tonsillitis and the beginning stages of recurrent and chronic tonsillitis share several common symptoms. These include:

• Fever above 38 degrees Celsius or 100.4 degrees Fahrenheit

• Extremely sore throat

• Redness or swelling of the tonsils

• White or yellow coating or coloring on the tonsils

• Dysphagia, or difficulty swallowing food

• Odynophagia, or pain when swallowing food

• Ear pain

Less Common Symptoms

If your condition worsens or you develop chronic (long-term) tonsillitis, you may experience other symptoms. These less common symptoms may include:

• Chronic bad breath (known as halitosis)

• Tenderness and swelling in the lymph nodes

• Cream-colored, pus-filled sacs on the tonsils

• Tonsil stones, or hard and sharp lumps on the tonsils

Rare Symptoms

While rare, sometimes a tonsillitis infection can spread to other body parts. When this happens, you or your child may develop additional symptoms. These symptoms are more likely to occur when you have recurrent or chronic tonsillitis. In such cases, surgery may be necessary to improve symptoms. Without proper treatment, you or your child may develop one or more complications, such as abscesses or changes to your kidney function.

Peritonsillar Abscesses

Peritonsillar abscesses, or pus-filled sacs that develop in the cavities of the throat and chest, are a complication of tonsillitis. If you or your child develop these sacs, it's possible to also experience the following symptoms:

• Severe sore throat

• Foul-smelling breath

• Lockjaw, or difficulty opening the mouth

• Fatigue

• Hoarse voice

• Severe swelling and redness of the tonsils

• Ear pain

Rheumatic Fever

Most types of tonsillitis are caused by viral or bacterial infections. Tonsillitis caused by group A beta-hemolytic streptococcus bacteria (the type of bacteria that cause strep throat) can also cause complications. The most common complication of this type of tonsillitis is rheumatic fever—a condition that causes inflammation in the joints, heart, and brain. If you or your child develop rheumatic fever, it's possible to experience:

• Pain and swelling in the joints

• Nodules (bumps) on the skin

• Shortness of breath or difficulty breathing

• Loss of control in your arm, leg, and facial muscles

• Chest pain

• Swelling in the stomach, hands, or feet

• Heart murmur (abnormal blood flow in the heart)

Glomerulonephritis

In rare cases, tonsillitis can develop into glomerulonephritis—a condition that causes inflammation of the glomeruli, which are the parts of the kidney that help filter toxins and waste. It's important to note that sometimes glomerulonephritis may be asymptomatic (or, not produce any symptoms). If symptoms do occur, you or your child may experience:

• Skin rash

• Pain in the joints

• Stomach pain

• Fever

• Shortness of breath

• Jaundice, or yellowing of the skin and eyes

• Difficulty urinating

• Fatigue

• Loss of appetite

• High blood pressure

Lemierre Syndrome

Lemierre syndrome (LS) is a potentially fatal (deadly) but treatable complication of tonsillitis. The condition can occur if tonsillitis spreads to the tissues in your neck and your bloodstream, causing blood clots to form in the lungs, liver, kidney, brain, and joints. If you or your child develop LS, the condition may cause:

• High fever

• Extreme swelling in the lymph nodes

• Swelling and stiffness in the neck

• Headaches

• Loss of energy and fatigue

• Chills

• Sore throat

• Cough

• Difficulty breathing

• Trouble swallowing food

• Dental or ear pain

• Abdominal pain

• Joint pain
  

When to See a Healthcare Provider

While most symptoms of acute tonsillitis resolve within a few days, it’s important to know when you or your child should reach out to a healthcare provider for medical help. It's worth calling your or your child's healthcare provider if you notice the following signs:

• Sore throat lasting longer than three days

• Pain when swallowing food

• Severe symptoms, such as high fever or muscle weakness

In addition, some symptoms prompt a call to 911 or immediately visiting the emergency room for medical care:

• Difficulty breathing or shortness of breath

• Excessive drooling in a child or infant

• Extreme difficulty with swallowing food or water

• Jaundice

• High fever

A Quick Review

Tonsillitis is an infection of the tonsils—which are two lumps of tissue located at the back of your throat. Most people who develop tonsillitis are children and teenagers. Severe sore throat, fever, and swelling in the tonsils are among the common symptoms of this condition.

It's important to note that most cases of acute tonsillitis resolve on their own. However, if you or your child develop recurrent or chronic tonsillitis, you may be at an increased risk of experiencing more serious complications—especially if the infection spreads to the rest of the body. If symptoms worsen and cause difficulty breathing or high fever, it's essential to get medical support from a healthcare provider to avoid complications from occurring.

Frequently Asked Questions

How long does tonsillitis last?

Acute (short-term) tonsillitis symptoms usually last three to four days. However, recurrent or chronic (long-term) tonsillitis may cause your symptoms to last much longer. If the condition affects you for longer than two weeks, it's important to seek medical attention from a healthcare provider.

Does tonsillitis get worse at night?

Sore throat is the hallmark symptom of tonsillitis and it can get worse at night. This happens because when you’re lying down, you can have postnasal drip. This occurs when excess mucus accumulates or builds up at the back of the throat, which can irritate your throat and cause pain. That said, sleeping with an extra pillow or with your head on an incline can improve symptoms at night.

Does ibuprofen work for tonsillitis?

Ibuprofen is not the first line of treatment for tonsillitis. However, non-steroidal anti-inflammatory drugs (NSAIDs) like Advil (ibuprofen) can help relieve symptoms such as throat pain or headache.

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