Tonsillitis: Symptoms, Types, and Causes of Tonsil Inflammation

Nighttime, a child's room, a hoarse "mo-om, my throat hurts" — and you're already there with a flashlight by an open mouth, trying to see what's going on with the tonsils. Sometimes you see red, enlarged tonsils, sometimes white spots, and sometimes you can't make anything out. Let's go through it step by step: what is called tonsillitis and when it's time to see a doctor.

Tonsillitis: What It Is and Why the Tonsils Become Inflamed

The tonsils are two lumps of tissue deep in the throat, one on each side. Together with the adenoids, they are part of the lymphatic system: they catch microbes that enter through the mouth and nose.

Tonsillitis is inflammation of the tonsils, meaning their swelling. Sometimes the adenoids swell along with them. The tonsils trap microbes, and when inflamed they become red and swollen.

Children get sick more often: tonsillitis occurs in children over two years old, and almost every child has it at least once. Teenagers and adults get it too, although in adults it is not as common.

Symptoms of Tonsillitis

Usually it all resembles a severe cold or flu: the tonsils on the sides of the throat are red and enlarged.

• sore throat and problems swallowing;
• high fever, cough, headache;
• nausea, ear pain, fatigue;
• enlarged and tender lymph nodes in the neck — felt as a lump on the side;
• white or yellow coatings and pus spots on the tonsils, bad breath.

Symptoms usually go away within 3–4 days, but may last longer.

Types of Acute Tonsillitis: How a Doctor Distinguishes Them

Acute tonsillitis is commonly called angina; there is also chronic tonsillitis, when inflammation returns again and again.

Doctors divide acute tonsillitis into forms based on the examination picture and the cause, and the doctor determines which form it is. Pus spots or white coatings are a sign of a more severe course, and with them people seek help without waiting a week.

You don't need to figure out the terms on your own: the doctor decides the type of inflammation and whether a swab is needed.

Viral or Bacterial Tonsillitis

It's not about the name but about the cause. Most often it is a virus — as with a cold; then there is no specific treatment, and the body copes on its own.

Bacterial tonsillitis, such as streptococcal angina, is less common. The viral variant is more common in younger children, the bacterial one in children aged 5–15. Most children and adults have the viral form.

They cannot be distinguished by eye. The doctor examines the throat, asks about symptoms, and may take a swab from the tonsils and the back of the throat: a rapid test gives a result in minutes, a laboratory culture in a few days, but it is more reliable. If the course is severe or does not resolve for a long time, a blood test for infectious mononucleosis is ordered.

Causes and Contagiousness

The cause is a virus (more often) or a bacterium such as streptococcus. Tonsillitis itself is not contagious, but the infections that cause it are: colds, flu.

Pathogens are transmitted from person to person, so transmission of infection is common with colds and flu.

Unilateral Tonsillitis and When to See a Doctor

The sources contain no data on unilateral tonsillitis. Any changes visible on one side can be assessed by a doctor during a throat examination.

See a doctor if symptoms have not passed within a week or the throat hurts again and again. Show the child earlier if the sore throat lasts more than two days, swallowing is painful or difficult, or the child is very lethargic.

Tonsillitis by itself is not a reason to call an ambulance; 103 or 112 — if breathing is difficult, the person cannot swallow or is drooling, as well as with severe sore throat that quickly worsens, swelling inside the mouth and throat, or if it is difficult to speak or open the mouth.

This material is for reference: it helps to understand what is happening but does not replace a doctor's consultation — it is better to show the throat to a specialist.

This content is for reference and does not replace a doctor's consultation. Medical disclaimer