Tonsillitis Symptoms, Causes, Treatments and Surgery

Tonsillitis is so common, it’s estimated nearly every child in America will experience it at least once. A painful inflammation of the throat, tonsillitis often goes away without treatment. But why do the tonsils become inflamed to begin with? Let’s look at what the tonsils are, what to do for tonsillitis and why taking out the tonsils isn’t always the answer.


Tonsillitis means ‘inflammation of the tonsils.’ To understand tonsillitis, you must first understand what the tonsils are. Many people know the tonsils are small areas of tissue on both sides of the back of the mouth and at the top of the throat. The tonsils used to be considered ‘useless’ tissue, so tonsillectomies (removal of the tonsils) was performed routinely on millions of children.

Today we know the tonsils actually are lymph nodes. These nodes serve to filter germs out of tissues in the oral cavity in order to prevent infections. Ironically the tonsils can, themselves, become infected. When that happens, they swell up and drain fluid. This condition is called ‘tonsillitis.’


Bacteria and viruses can infect the tonsils and cause them to become inflamed. Often the Streptococcus group of germs causes tonsillitis, but not every case of tonsillitis is caused by strep throat.


Anyone can get tonsillitis, but it’s much more common in children than adults. Some symptoms of tonsillitis may include:

  • Visibly swollen, inflamed tonsils
  • Swollen tonsils with white patches and/or drainage
  • Sore throat that lasts more than two days
  • Ear pain
  • Headache
  • Enlarged lymph nodes around the jaw
  • Fever
  • Chills
  • Painful or difficult swallowing
  • Difficulty breathing due to severely enlarged tonsils


Sometimes tonsillitis requires no treatment. If the tonsils aren’t extremely painful and the inflammation goes away within a couple of days, then the body likely resolved the infection on its own.

If symptoms become severe or don’t clear up within a couple of days, you should consult a healthcare professional to see if strep throat is causing the tonsillitis. Your provider can perform a ‘rapid strep’ test in the office. If strep is the culprit, you will be given antibiotics. Take the antibiotics (or give them to your child) exactly as directed. Take all of the antibiotics in the prescription. Do not stop taking the antibiotics just because you (or your child) start to feel better. In order to make sure you have destroyed all of the strep bacteria, you need to take all of the antibiotics. Symptoms should improve soon after starting the antibiotics, but this is no indication the infection is gone.

You also can provide comfort care to your child, who may find it uncomfortable to eat or drink because of a raw throat. Here are a few things to try:

  • Hydration is key, especially for young children. Give them either warm fluids like tea with honey or icy treats like frozen fruit-flavored pops, whichever one is more soothing.
  • Place cool (not frozen) cloths on the forehead and back of the neck to relieve a fever.
  • Give children acetaminophen (Tylenol) in an appropriate dose for pain and fever control. (Never give children aspirin.)
  • If your child is older, offer lozenges that contain benzocaine, which is a numbing agent. Do not give these to younger children, as they can be a choking hazard.
  • Allow your child to enjoy quiet time, television or reading while she or he feels ill.

Occasionally, in cases of severe, recurring tonsillitis, your healthcare provider may recommend a tonsillectomy. This surgery usually goes very well, but it can have serious complications. Have a long conversation with your surgeon about the pros and cons of having your child’s tonsils removed. It is possible to live a healthy life without the tonsils.


It is virtually impossible to prevent tonsillitis. Try to keep your children away from other children who have a known case of strep. If your child has strep, keep him or her away from other children until he or she has been on antibiotics for at least 24 hours.


In very rare instances, tonsillitis caused by strep throat can cause complications, including rheumatic fever, kidney problems and an abscess around the tonsils. However, most cases of tonsillitis will either clear up without treatment or will respond to antibiotics (when caused by strep bacteria). Just monitor your child to make sure he or she improves over the course of time. If you notice symptoms getting worse, or if your child isn’t responding to antibiotics, then call your healthcare provider’s office.