Tonsillitis occurs when the tonsils become infected, and can be caused by either bacteria or viruses. Symptoms of tonsillitis may include white or yellow spots of pus on the tonsils, sore throat, swollen lymph glands, pain when swallowing, fever and bad breath. Glandular fever can cause tonsillitis, but other viruses may also be responsible. Tonsillectomy (taking the tonsils out surgically) may be recommended in severe cases but is now rare.
The tonsils are the two small buds of tissue located at the back of the mouth and are part of the immune system. They make antibodies and white blood cells (lymphocytes) to attack germs inside the mouth. This makes the tonsils part of the first line of defence against bacteria in food or air. Tonsillitis occurs when the tonsils become infected, and can be caused by either bacteria or viruses. Tonsillitis can develop in people of all ages. However, adults who get tonsillitis have generally had more infections in their lives, so they no longer get sick as often as children.
The signs and symptoms of tonsillitis include:
- White or yellow spots of pus on the tonsils.
- Sore throat - some children complain of pain in their tummy, rather than a sore throat.
- Swollen lymph glands under each side of the jaw.
- Pain when swallowing.
- Bad breath.
Streptococcus and glandular fever
When tonsillitis is caused by bacteria (about 15 per cent of all infections), the most common type of bacteria that causes tonsillitis are streptococci. It is not easy to tell when tonsillitis is caused by bacteria; your doctor may do a throat swab (gently rubbing sterile cotton wool on a stick over the tonsil) and send it for testing.
Glandular fever is one of the viral illnesses which can cause tonsillitis, but there are many other viruses that may also be responsible. Antibiotics do not make a difference if the tonsillitis is caused by a viral infection.
Complications of tonsillitis
Tonsillitis can lead to a number of complications, including:
- Chronic tonsillitis- infection of the tonsils which does not clear up; the person may go on feeling unwell and tired.
- Secondary infections - the infection can spread to the nose, sinuses or ears.
- Glue ear (otitis media) in children - the adenoids are part of the same group of lymph nodes as tonsils. When the adenoids swell up (usually when the tonsils are also large), they can block the thin tube which goes from the back of the throat to the middle ear. This is the tube that you push air along when you ‘pop’ your ear. If this tube (eustacian tube) stays blocked most of the time, sticky fluid forms in the middle ear which interferes with hearing (a glue ear).
- Quinsy - if the infection spreads into the tissue around the tonsils an abscess in the throat can form, also known as a peri-tonsillar abscess. This causes severe pain and can interfere with swallowing and even breathing. Antibiotics may help, but sometimes an operation is needed to drain the abscess.
Because most attacks of tonsillitis are cause by viruses, most of the treatment is aimed at helping to relieve the symptoms such as pain and fever. Paracetamol can help. Most children with tonsillitis do not feel well and it hurts them to swallow. Try cool drinks (cold drinks can hurt), ice blocks and ice cream are popular. Do not worry if a child stops eating for a day or two, mostly they pick up quickly when the infection has gone.
Many times antibiotics are prescribed. They may help some people, but often they are not needed. Sometimes having antibiotics with viral tonsillitis can cause unwanted effects such as rashes.
If someone has many attacks of tonsillitis each year, taking the tonsils out may help, but the operation can be unsafe and most doctors are reluctant to recommend it.
Where to get help
- Your doctor
- NURSE-ON-CALL Tel. 1300 60 60 24 – for expert health information and advice (24 hours, 7 days)
Things to remember
- The tonsils sit at the back of the mouth and are part of the body’s immune system.
- The most common cause of tonsillitis is viral infections.
- Operating to take the tonsils out may help if the person is having many infections, but the operation is complicated and may be unsafe.
You might also be interested in:
Want to know more?
Go to More information for support groups, related links and references.
This page has been produced in consultation with and approved by:
(Logo links to further information)
Child and Youth Health (CYH)
Fact sheet currently being reviewed.
Last reviewed: June 2011
Content on this website is provided for education and information purposes only. Information about a therapy, service, product or treatment does not imply endorsement and is not intended to replace advice from your doctor or other registered health professional. Content has been prepared for Victorian residents and wider Australian audiences, and was accurate at the time of publication. Readers should note that, over time, currency and completeness of the information may change. All users are urged to always seek advice from a registered health care professional for diagnosis and answers to their medical questions.
Content on this website is provided for education and information purposes only. Information about a therapy, service, product or treatment does not imply endorsement and is not intended to replace advice from your qualified health professional. Content has been prepared for Victorian residence and wider Australian audiences, and was accurate at the time of publication. Readers should note that over time currency and completeness of the information may change. All users are urged to always seek advice from a qualified health care professional for diagnosis and answers to their medical questions.
For the latest updates and more information, visit www.betterhealth.vic.gov.au
Copyight © 1999/2013 State of Victoria. Reproduced from the Better Health Channel (www.betterhealth.vic.gov.au) at no cost with permission of the Victorian Minister for Health. Unauthorised reproduction and other uses comprised in the copyright are prohibited without permission.