Acute Tonsillitis

By Medically reviewed by hellodoktor


What is Acute Tonsillitis?

Acute tonsillitis is an infection of the tonsils caused by one of several possible types of bacteria or viruses. Symptoms of acute tonsillitis can either come on suddenly, or be of a gradual onset of a sore throat usually accompanied by a fever.

How common is Acute Tonsillitis?

It is a very common condition, most frequent in children aged 5-10 years and young adults between 15 and 25 years. Please discuss with your doctor for further information.


What are the symptoms of Acute Tonsillitis?

The common symptoms of Acute Tonsillitis are:

  • Sore throat
  • Fever
  • Difficulty swallowing saliva
  • Drooling
  • Ear pain with swallowing
  • Bad breath
  • Tonsil surface may be bright red or have a grayish-white coating (exudate).
  • Lymph nodes in the neck may be swollen.

Strep throat is a specific type of infection caused by the Streptococcus bacteria. Strep tonsillitis can cause secondary damage to the heart valves (rheumatic fever) and kidneys (glomerulonephritis). It can also lead to a skin rash (for example, scarlet fever), sinusitis, pneumonia, and ear infections.

There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.

When should I see my doctor?

You should contact your doctor if you have any of the following:

  • Extensive swelling of the throat
  • A fever of over 30˚ c
  • Stiff neck
  • Muscle weakness
  • A sore throat that persists for longer than 2 days


What causes Acute Tonsillitis?

Tonsillitis can be caused by a virus, such as the common cold, or by a bacterial infection, such as strep throat. According to the American Academy of Family Physicians (AAFP), an estimated 15 to 30 percent of tonsillitis cases are due to bacteria. Most often it’s strep bacteria.

Viruses are the most common cause of tonsillitis. The Epstein-Barr virus can cause tonsillitis, which can also cause mononucleosis.

Children come into close contact with others at school and play, exposing them to a variety of viruses and bacteria. This makes them particularly vulnerable to the germs that cause tonsillitis.

Risk factors

What increases my risk for Acute Tonsillitis?

There are many risk factors for Acute Tonsillitis, such as:

  • Immune deficiency
  • A family history of tonsillitis or atopy

Diagnosis & treatment

The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.

How is Acute Tonsillitis diagnosed?

Diagnosis is based on a physical examination of your throat. Your doctor may also take a throat culture by gently swabbing the back of your throat. The culture will be sent to a laboratory to identify the cause of your throat infection.

How is Acute Tonsillitis treated?

Treatment of acute tonsillitis is largely supportive and focuses on maintaining adequate hydration and caloric intake and controlling pain and fever. Inability to maintain adequate oral caloric and fluid intake may require IV hydration, antibiotics, and pain control. Home intravenous therapy under the supervision of qualified home health providers or the independent oral intake ability of patients ensures hydration. Intravenous corticosteroids may be administered to reduce pharyngeal edema.

Airway obstruction may require management by placing a nasal airway device, using intravenous corticosteroids, and administering humidified oxygen. Observe the patient in a monitored setting until the airway obstruction is clearly resolving.

Tonsillectomy is indicated for individuals who have experienced more than 6 episodes of streptococcal pharyngitis (confirmed by positive culture) in 1 year, 5 episodes in 2 consecutive years, or 3 or more infections of tonsils and/or adenoids per year for 3 years in a row despite adequate medical therapy, or chronic or recurrent tonsillitis associated with the streptococcal carrier state that has not responded to beta-lactamase–resistant antibiotics.

Tonsillitis and its complications are frequently encountered. Antibiotics cure most patients with bacterial tonsillitis, and surgery usually cures patients with infections and complications that are refractory to medical management. Better understanding of the immunology of tonsillitis, actively tracking patterns of bacterial and viral pathogenicity and resistance, and exploring novel technologies for tonsillectomy allow physicians to continue to build on their long experience with these conditions.

Consider transfer of patient care when tonsillitis or its complications cannot be managed safely and expediently. Ensure airway protection for transfer. Ensure that appropriately trained personnel accompany the patient during transfer. Children younger than 3 years may require transfer because of the special care needed during tonsillitis or its complications. Patients with syndromic diagnoses (eg, trisomy 21) and patients with hematologic problems may benefit from transfer to facilities that have the availability of subspecialist care.

Discharge of the patient from the hospital occurs after the patient and caregivers can demonstrate compliance with oral pain medication and antibiotics. To confirm clinical improvement, follow-up care by telephone contact or physical examination may be useful in 2-4 weeks after the acute episode. Follow-up throat swabs and cultures are usually not necessary, unless family or personal history of rheumatic fever exists, significant recurrent tonsillitis is evident, or family members continue to reinfect each other.

Consultations with infectious disease, hematologic, and pediatric subspecialists are valuable in selected cases.

Lifestyle changes & home remedies

What are some lifestyle changes or home remedies that can help me manage Acute Tonsillitis?

The following lifestyles and home remedies might help you cope with Acute Tonsillitis:

  • Resting enables the body to focus its energy on fighting the infection rather than using it on daily activities.
  • Drinking plenty of fluids will prevent the throat from drying out and becoming more uncomfortable. When the body is fighting an infection, it needs more hydration than normal. Warm, preferably caffeine-free drinks can also soothe.
  • Gargling with saltwater might help with discomfort.
  • Sucking throat lozenges may help, and these are readily available over the counter or online.
  • Using air humidifiers or sitting in a steamy bathroom can alleviate the irritation caused by dry air. Various humidifiers can be purchased online.
  • Avoiding irritants, such as tobacco and smoky locations.
  • Taking medication, such as ibuprofen or acetaminophen, can help with pain and fever.

If you have any questions, please consult with your doctor to better understand the best solution for you.

Hello Health Group does not provide medical advice, diagnosis or treatment.


Review Date: May 10, 2018 | Last Modified: September 13, 2019

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