Tonsillitis

Last published:Dec 06, 2021

Tonsillitis is a type of sore throat. It can make you feel very ill for a few days. Both adults and children can get tonsillitis, although it is more common in children.

You can use our information to talk to your doctor and decide which treatments are best for you or your child. 

What is tonsillitis?

Tonsillitis is an infection in the tonsils. Your tonsils are two small mounds on either side of the back of your throat. They can get infected with viruses or bacteria, but most cases of tonsillitis are caused by viruses.

When bacteria do cause tonsillitis, the most common type are called Streptococcus. You may hear a sore throat or tonsillitis caused by these bacteria called strep throat.

What are the symptoms?

Tonsillitis causes a bad sore throat that lasts for several days.

You (or your child) will probably have a fever. You may also:

• have a headache

• not feel like eating

• notice white spots on your tonsils, and

• be able to feel lumps under your jaw and in your neck (these are swollen lymph glands).

You may need a few days off school or work.

If your symptoms (or your child's) are very bad or last longer than three days, you should see your doctor.

What treatments work?

Most people with tonsillitis feel better in about a week.

Taking over-the-counter pain medicines such as paracetamol, aspirin, or ibuprofen should help with your symptoms while you recover. You can give your child versions of paracetamol and ibuprofen that are made for children.

But don't give aspirin to children under 16, as it can cause a rare but serious illness called Reye's syndrome, which leads to swelling in the liver and brain.

For people with severe symptoms, doctors sometimes give medicines called corticosteroids. These are strong anti-inflammatory medicines that help reduce swelling and pain. They can be given either as pills or as an injections. They are not usually given to young children.

Some people find that drinking warm tea with honey or gargling with salt water soothes their pain. Sucking throat lozenges or hard sweets can also help.

But don't give hard sweets or lozenges to young children, because they could choke on them. And don't give honey to children under a year old, as there is a chance they could develop a serious illness called botulism.

Will antibiotics help?

Antibiotics will help only if your tonsillitis is caused by bacteria. Antibiotics do not help with infections caused by viruses.

If your doctor thinks you or your child might have tonsillitis caused by bacteria, you will probably be given a rapid antigen test. This test involves rubbing a cotton swab on the back of your throat to collect a sample of fluid. This sample is then tested for signs of the Streptococcus bacteria.

The test is fast, giving results in minutes, but it isn't completely reliable. If the test is negative for Streptococcus, your doctor may do another test called a throat culture. It can take a day or two to get the results.

Your doctor may give you a prescription for antibiotics while you are waiting for the throat culture results. That way, if the throat culture comes back positive for Streptococcus, you can fill the prescription and start taking the antibiotics straight away.

If your tonsillitis is caused by bacteria, antibiotics can reduce how long you have symptoms for, but only by about a day. Antibiotics may also help reduce the chance that the infection will lead to other problems, such as a sinus infection or ear infection. 

Antibiotics can have side effects, but these are usually mild. They include an upset stomach, diarrhoea, or a rash.

What about surgery to remove the tonsils?

If you or your child gets tonsillitis a lot, you may want to think about having surgery. Some people choose to have surgery to remove their tonsils if tonsillitis has been interfering with their life by making them ill a lot.

The operation is done in hospital and you (or your child) will probably have a general anaesthetic, so you won't be awake during the operation. Most people are able to go home the same day.

If your child has his or her tonsils removed, they may get fewer throat infections in the short term.  

Surgery has some risks. You should discuss these with your doctor. They include:

• heavy bleeding during the operation or afterwards

• an allergic reaction to the anaesthetic

• an infection, and

• swelling in your mouth and throat after the surgery.

What will happen?

Tonsillitis usually clears up on its own within a week.

Sometimes tonsillitis leads to other problems, including ear infections, sinus infections, and a rash (called scarlet fever).

Although rare, it's also possible to get more serious problems after having tonsillitis, such as an abscess in your throat. This can make your throat very sore, and you may have difficulty opening your mouth. Occasionally, this can cause breathing problems. If you get any of these symptoms, you should see your doctor. 

If your tonsillitis is caused by Streptococcus bacteria, you could get rheumatic fever, although this isn't common in developed countries. This causes pain and swelling in your joints, a fever, and pain in your chest.

If you have any questions or concerns, you should contact your doctor.

Last published:Sep 16, 2025

Sore throats are very common and usually clear up on their own within a few days. They can be painful, but most people recover quickly. In the meantime, there are things you can do at home to make yourself feel more comfortable.

Sometimes a sore throat doesn’t go away by itself, and you will need to see a doctor. You can use this information to talk to your pharmacist or doctor about which treatments are best for you or your child.

What is a sore throat?

Sore throats are common and are often part of another illness, such as a cold. You might also hear a sore throat called pharyngitis. 'Pharynx' is another word for the throat.

There are many possible causes for a sore throat. The most common cause is a virus, such as the common cold or flu. Some viruses can cause very severe sore throats. For example, glandular fever (also called infectious mononucleosis) is caused by a virus.

Sore throats can also be caused by bacteria. When this happens, it’s usually due to Streptococcus. A sore throat caused by this bacteria is called strep throat. Other types of bacteria can also cause a sore throat, but these are less common.

Fungal infections can also cause a sore throat. The most common type is oral thrush, which is caused by a type of fungus called Candida.

This information is about sore throats caused by the common cold and Streptococcus.

What are the symptoms of a sore throat?

Common symptoms of a sore throat and other related symptoms may include:

• Pain at the back of the throat, which may feel worse when swallowing

• Redness or white patches at the back of the throat

• Very tender or swollen glands in the neck

• Painful sinuses

• A cough with mucus

• Headache

• A temperature of more than 38°C (101°F).

Most sore throats aren’t serious. In most cases, these symptoms will improve on their own with simple care at home. If you or your child’s symptoms do not improve after a week, you should speak to a doctor.

Sore throats can sometimes be a sign of more serious illness. You should speak to a doctor straight away if you or your child has:

• Difficulty swallowing or breathing

• Blood in saliva or phlegm

• Excessive drooling (in young children)

• Signs of dehydration (such as very little urine or dry mouth)

• Joint swelling and pain

• Rash

• A temperature of 38°C (101°F) or higher in infants under 3 months old

• A temperature of 39°C (102°F) or higher in infants 3-6 months old

• A very high temperature, feeling very hot or cold, shivering, or a high temperature that lasts more than 5 days.

What are the treatment options for a sore throat?

Most sore throats get better on their own within a few days. In the meantime, there are several things you can do at home to help you feel more comfortable.

Home treatments to relieve a sore throat

There are some simple things you can do yourself to help soothe a sore throat, including:

• Take over-the-counter painkillers such as paracetamol or ibuprofen. These medicines come as tablets, or as chewable tablets or syrups, which are easier for children to take.

• Gargle with warm, salty water. Children should not try this.

• Suck throat lozenges or use anaesthetic sprays. These work by soothing or numbing the back of your throat. Do not give lozenges to young children because of the risk of choking.

Aspirin is another painkiller which might help, but do not give aspirin to children or teenagers. This is because it can very occasionally cause a condition called Reye's syndrome, which affects the brain and liver. Aspirin and ibuprofen can also irritate the stomach, and can cause ulcers and bleeding in some people.

It is important to be careful with medicines for sore throats. Many ‘cold and flu’ medicines contain paracetamol, so be careful if you or your child are taking more than one medicine at a time. Taking too much paracetamol is dangerous, because it can damage the liver. It's a good idea to talk to a pharmacist if you have any questions or concerns about which medicine is best for you or your child.

Antibiotic treatment for strep throat

Doctors might do some tests to find out if you have strep throat. These tests involve gently rubbing a cotton swab on the back of your throat. If you test positive for strep throat, your doctor will recommend antibiotics. Antibiotics kill bacteria so they work against strep throat.

Some test results can take a few days. If your doctor thinks you probably have strep throat, they may give you antibiotics before the results are back.

Antibiotics are usually taken as tablets, but syrups are available for children. You’ll usually need to take these for 5-10 days.

If you don't start to feel better within 3 days of starting antibiotics, you should tell your doctor.

It's very important to take the antibiotics for the number of days your doctor tells you to, even if you start feeling better. If you stop taking them too early, some bacteria may survive and begin to grow again. This means your infection could come back and be more difficult to treat.

Antibiotics can have side effects. The most common are nausea (feeling sick), vomiting, or diarrhoea. Some people get a rash, which could suggest a mild allergic reaction. Talk to your doctor if you get a rash or any other side effects. If you’re allergic to any antibiotics, such as penicillin, you should also tell your doctor.

Taking antibiotics for strep throat often helps you feel better within a day. They can prevent the infection from causing problems like ear infections, throat abscesses, and (in rare cases) rheumatic fever. Antibiotics also help stop the infection from spreading to other people.

What happens next?

Sore throats usually clear up on their own in a few days, and complications are very rare. Sometimes the infection that causes a sore throat can lead to problems such as hoarseness or loss of voice, an ear infection, or a sinus infection. If you think you have an ear or sinus infection, see your doctor.

As sore throats are very common, you are likely to get another one in the future. This is particularly the case for children. However, if you or your child keep getting sore throats, you should see a doctor.

Last published:Aug 17, 2021

This information tells you what to expect when your child has an operation to remove his or her tonsils. It explains how the operation is done, how it can help, what the risks are, and what to expect afterwards.

You can use our information to discuss your child’s operation with the doctors and nurses treating them.

What is a tonsillectomy?

A tonsillectomy is an operation to remove the tonsils. Your tonsils are two small, almond-shaped mounds that sit on either side of the back of your throat. They are part of the body's system for fighting infections (the immune system).

The tonsils can be removed in several ways, including cutting them out with a scalpel, or removing them with a special surgical tool that uses heat. This method is called diathermy.

Why might my child need to have a tonsillectomy?

Tonsillitis happens when bacteria or a virus infects the tonsils. It causes painful, swollen tonsils and a fever.

Repeated episodes of tonsillitis can be miserable for a child. It can cause:

• frequent illness and painful sore throats

• a lot of time off school, and

• trouble sleeping.

Having a tonsillectomy can’t stop a child from getting tonsillitis. But it might reduce the number of episodes they get for about two years after the operation.

This might not sound like much of a benefit. But if your child gets repeated bouts of severe tonsillitis, you might consider it worthwhile.

But the tonsils have an important job to do in children’s immune systems: for example, they might play a role in fighting other types of infection.

So doctors are cautious about suggesting this operation. They will usually only recommend that a child has their tonsils removed if they have had:

• at least seven episodes of tonsillitis in the past year or

• at least five episodes of tonsillitis in the past two years or

• at least three episodes of tonsillitis in each of the past three years.

What will happen?

The operation takes about 45 minutes. Your child will probably have to spend a night in hospital. This is so that your doctor can keep an eye out for any problems that can happen immediately after the operation, such as bleeding.

Your child will probably have a general anaesthetic, which means that they will be asleep during the operation.

During the operation:

• your child lies on their back with a support under the shoulders, so that their head is tipped back a little

• a breathing tube is placed into your child's mouth, along with an instrument to hold the mouth wide open

• the surgeon sits behind your child's head to do the operation, looking into the mouth upside-down.

Cutting out the tonsils

There are several ways to remove the tonsils. In an operation where the tonsils are cut out:

• the surgeon gently cuts out the tonsils and uses a small scoop to lift them out

• the surgeon then stops the bleeding from the cuts, using either stitches or heat (diathermy)

• if your child has stitches, these will dissolve after the operation, so they won’t need to be removed

• diathermy stops bleeding by heating the blood vessels to seal them closed.

Removing the tonsils using heat (diathermy)

With this technique, the surgeon uses an electrical surgical tool that uses heat waves to remove the tonsils.

This instrument can then be used to seal up the wound afterwards.

Other methods

Other ways of removing the tonsils are sometimes used, including:

• coblation. This uses radio waves at a low temperature to destroy the tonsils, and

• laser surgery. As the name suggests, the surgeon uses a laser to destroy the tonsils.

The type of surgery you are offered might depend on what is available where you live, and whether there is a surgeon who specialises in a particular method.

What are the risks?

All operations have risks, and your surgeon should talk to you about them before your child has surgery.

One common problem is side effects caused by anaesthetics. The most common problem is children feeling nauseous (sick) for a while after they wake up.

Serious problems are rare, but doctors will keep a close eye on your child's breathing, heartbeat, temperature, and blood pressure.

Very rarely, children have an allergic reaction to one of the anaesthetic drugs. You should tell the doctors before the operation if your child has any allergies.

You should also tell your doctor if your child has had a cough or cold in the week before the operation.

Some problems (doctors call them complications) can happen during or soon after the operation, while some can happen a while later.

The list of possible complications below might look long, but remember, these are things that might happen, not things that definitely will happen. Many children who have this operation have no problems at all.

Problems that can happen during or soon after the operation

• Bleeding is a common complication with this surgery. The bleeding is usually stopped by putting a pad of gauze over the wound. If this doesn't work, your child might need to go back to the operating theatre to have the bleeding stopped. Rarely, some children need a blood transfusion.

  Bleeding can sometimes happen a day or so after the operation. If this happens, your child might need more treatment to stop the bleeding.

• Damaged teeth. Sometimes, loose teeth can come out during a tonsillectomy, or a tooth can be chipped by the instrument that holds the mouth open.

• Chest infection. Small amounts of blood and tissue from the operation can sometimes get into the child’s throat and lungs. This can cause a chest infection and breathing problems. If this happens your child will be treated with antibiotics and possibly oxygen.

• Dying during the operation. It’s extremely rare for a child to die during this operation. It happens to about 1 in every 20,000 children who have a tonsillectomy.

Possible longer-term problems

Long-term problems after this operation are rare, but they can happen. They include:

• Narrowing of the area at the back of the nose. This can make breathing through the nose more difficult.

• Your child’s voice might sound nasal. Speech therapy can help with this.

• Difficulty swallowing and pain in parts of the face can last for some months or even years. Some children need an operation to treat these problems.

What to expect afterwards

Your child will probably need to stay in hospital overnight.

They will be able to drink and will be encouraged to eat normally as soon as possible. This can help with the healing process.

After about 12 hours, a white or yellowish membrane (thin skin) appears where the tonsils were. It's nothing to worry about and isn't a sign of infection. It's just new skin growing over the wound.

Will my child be in pain?

Your child won't feel any pain during the operation but they will have a very sore throat afterwards. They might find it hard to swallow.

Your child's jaw and mouth might also hurt because their mouth was held wide open during the operation.

The sore throat usually gets worse after the first day and can sometimes last for more than a week before it gets better.

Your child will be given regular doses of painkillers while in hospital. If these don't work well enough, it's important to tell the nurse. Being in pain can slow your child's recovery.

For example, some children might refuse to eat if their throat hurts. Or they might need to stay in hospital longer.

Going home

When you get home, your child will probably feel a little unwell and have bad breath for a few days. Your child might also have earache for a few days. If painkillers don't work, you should see your doctor, as your child might have an ear infection.

If your child's throat starts to bleed again, they need to go to hospital to make sure it's not serious.

Most children need a couple of weeks to get back to normal. It's best to keep your child off school for this time so they don't mix with other people who might have coughs or colds.

Encourage your child to eat as normally as possible. Although it might be painful, eating foods such as toast and cereal can help healing by scraping away dead tissue.

The thin white skin where the tonsils used to be will stay for about 10 days to 14 days.

This new skin can sometimes become infected. This will be painful, and your child will have a fever and bad breath. If you think your child has an infection, call your doctor. Your child will need treatment with antibiotics.