What is Tonsillitis?

What is Tonsillitis?

Side by side diagram of healthy tonsils and tonsillitis

Tonsillitis is an infection of the tonsils. The tonsils are two lymph nodes in the back of your throat that trap bacteria and disease-causing agents to help prevent them from entering the body. When tonsils are infected, they become inflamed and swollen, which can cause symptoms such as a sore throat, fever, or difficulty swallowing.

Tonsillitis can occur at any age but is most common in children. It can be caused by viral or bacterial infections, and treatment for tonsillitis depends on the cause. Surgical removal of the tonsils will only be performed if the condition persists despite other treatment methods or if the condition causes other complications.

Is tonsillitis contagious?

Tonsillitis is not contagious, but the virus or bacteria that causes tonsillitis can be contagious and can be passed to others by:

  • Kissing
  • Sharing utensils such as forks, spoons, and knives
  • Sharing food or drinks
  • Touching your nose or mouth after touching a surface that is contaminated with the bacteria or virus
  • Being in close contact with someone who is sick, especially inhaling after a sick person coughs or sneezes

Tonsillitis vs. strep throat

Strep throat is a bacterial infection of the throat. It is often confused with tonsillitis because both conditions can produce similar symptoms, including sore throat, pain when swallowing, red or swollen tonsils, and fever. However, strep throat is specifically caused by an infection of the Streptococcus pyogenes bacterium, both a viral or bacterial infection can cause tonsillitis.

The Streptococcus pyogenes bacterium most often causes bacterial tonsillitis, but in general, most cases of tonsillitis are caused by viruses.

Viral cases of tonsillitis and strep throat will not respond to antibiotics.

Types of Tonsillitis


Three different types of tonsillitis are classified based on the duration and/or recurrence of symptoms. The types of tonsillitis are: 

  • Acute tonsillitis - Symptoms occur suddenly and typically last only a few days, though they can persist for about two weeks in some cases. Symptoms include red and swollen tonsils, sore throat, and difficulty swallowing. Symptoms of acute tonsillitis will typically go away within two weeks, with or without antibiotics.
  • Recurrent tonsillitis - A person experiences several different episodes of tonsillitis infection, meaning symptoms subside and reoccur later. In general, recurrent tonsillitis is characterized by at least seven episodes in one year, at least five episodes per year for two years, or at least three episodes per year for three years.
  • Chronic tonsillitis – Chronic tonsillitis is considered long-term. People with chronic tonsillitis often experience persistent symptoms of swollen lymph nodes, sore throat, and bad breath. Chronic tonsillitis can be treated with antibiotics and pain-relieving medication, but in some cases, the tonsils may need to be surgically removed.

Signs & Symptoms of Tonsillitis


Most people with tonsillitis experience symptoms that affect the area around the throat, but some people also experience general feelings of illness.

Signs and symptoms of tonsillitis may include:

  • Red, swollen tonsils
  • Sore throat
  • Painful or difficulty swallowing
  • Fever
  • Swollen lymph nodes in the neck
  • White spots or a white or yellow coating on the tonsils
  • Scratchy voice
  • Headache
  • Pain or stiffness in the neck
  • Pain in the ears
  • Bad breath
  • Difficulty sleeping
  • Fatigue
  • Loss of appetite
  • Stomachache 

If you are experiencing these tonsillitis symptoms, you should schedule an appointment with a primary care doctor. The doctor will examine the throat and tonsils to determine if tonsillitis is the cause, and the doctor may also take a throat culture to rule out strep throat.

Once the cause of symptoms is determined, your primary care doctor will recommend the best treatment method.

Symptoms of tonsillitis in children

Children with tonsillitis are more likely to experience stomach aches and vomiting symptoms. If they have a sore throat or difficulty swallowing, they may also exhibit signs of drooling or may refuse to eat.

Because children have a higher risk of tonsillitis, you should visit a pediatrician if your child has a sore throat for more than two days, has pain when swallowing, or feels sick or fatigued.

What Causes Tonsillitis?


Tonsils act as the first line of protection from viruses and bacteria that enter the mouth, and this role makes them susceptible to infection. Tonsilitis is most often caused by viral infections, such as adenoviruses or influenza viruses.

A bacterial infection can also cause tonsillitis. The most common bacterium that causes tonsillitis is Streptococcus pyogenes, the same bacterium that causes strep throat.

Risk Factors for Tonsillitis

Risk Factors

Age is the main risk factor for tonsillitis. Tonsillitis caused by bacterial infections is more common in children between the ages of 5 and 15, while very young children have a higher risk of tonsillitis caused by viral infections.

Children who attend school, daycare, or camp are more likely to spread the germs that can cause tonsillitis, as they are frequently in close contact with each other. Adults can still get tonsillitis, but it is not as common. Adults who frequently work with children, like teachers, may have a higher risk of infections that can lead to tonsillitis.

How to Prevent Tonsillitis


Certain measures can be taken to reduce the risk of tonsillitis, and they primarily involve maintaining proper hygiene. Such preventative measures include:

  • Frequently washing your hands
  • Avoiding shared utensils
  • Avoiding shared food and drinks
  • Replacing your toothbrush after you have been sick
  • Avoiding contact with someone who is sick or has a sore throat

If you or your child has tonsillitis, you can help prevent it from spreading to others by:

  • Staying home/avoiding contact with others
  • Covering the nose and mouth with a tissue when coughing or sneezing
  • Washing your hands after coughing or sneezing
Get Care

Trust NewYork-Presbyterian for Tonsillitis Care

If you or a loved one is experiencing symptoms of tonsillitis, schedule an appointment with a doctor to determine the cause of your symptoms and explore the treatment options  that are best for you. NewYork-Presbyterian offers flexibility and care for your needs by scheduling early, late, or weekend appointments, as well as same-day appointments for critical needs.

NewYork-Presbyterian accepts most insurance policies, and we make referrals to our experienced healthcare specialists as needed. We also utilize a patient portal, connecting you with your team of medical professionals and providing you with easy access to your medical records. Some situations can be addressed through video visits alone*.

Schedule an appointment or virtual urgent care visit* with NewYork-Presbyterian or at a medical group location today.

*Restrictions apply