Alternate Names

  • acute tonsillitis
  • subacute tonsillitis
  • chronic tonsillitis
  • Tonsils


Tonsillitis is an inflammation or infection of the tonsils.

What is going on in the body?

The body has two sets, or pairs, of tonsils. The palatine tonsils can be seen at the back of the throat. The lingual tonsils are at the back of the tongue and cannot be seen by looking in the mouth. Tonsillitis usually means the inflammation or infection of the palatine tonsils. Sometimes, however, the infection can involve the lingual tonsils and lymph nodes in the back of the throat.


What are the causes and risks of the infection?

Common causes of acute tonsillitis may include:
  • bacteria, such as streptococci or Hemophilus bacteria
  • diphtheria, a serious disease that produces a false membrane in the throat. Diphtheria can be prevented by the DTaP vaccine.
Subacute tonsillitis is most commonly caused by Actinomyces, a normal mouth bacterium that can cause infection. In chronic tonsillitis, there is a long-standing infection that is almost always bacterial.


What can be done to prevent the infection?

A person can get acute tonsillitis by:
  • coming into contact with someone who has strep throat or mononucleosis
  • having strep throat that develops into tonsillitis
There is no way to prevent subacute or chronic tonsillitis.


How is the infection diagnosed?

A healthcare professional can diagnose acute tonsillitis based on the person's health history and a physical exam. A throat culture can help identify the organism causing the infection. A complete blood count (CBC) can also help determine if the infection is caused by a virus or bacteria.
If the individual has infectious mononucleosis, the lymph nodes in the neck, armpit, or groin will be enlarged. An antibody titer may be done to check for antibodies to the Epstein-Barr virus. Rapid in-office tests may also be used to assist in making the diagnosis.
A healthcare professional can diagnose subacute or chronic tonsillitis based on a person's health record and a physical exam.

Long Term Effects

What are the long-term effects of the infection?

Usually, no significant long-term effects result from any of the three forms of tonsillitis. However, difficulty swallowing or breathing during sleep can result if the chronic infection causes enlargement of the tonsils. The healthcare professional may recommend a tonsillectomy, or removal of the tonsils, if there are recurrent infections or difficulties with swallowing and breathing.

Other Risks

What are the risks to others?

Streptococcal, diphtheria, and Epstein-Barr infections are all contagious.


What are the treatments for the infection?

Acute tonsillitis is usually treated with:
  • pain medication
  • oral fluids
  • medications to lower fever
For acute tonsillitis caused by strep bacteria, antibiotics will usually cure the infection. Unfortunately, some types of streptococcal bacteria are becoming resistant to penicillin. This means higher doses of amoxicillin or a different antibiotic need to be used.
Since antibiotics are not effective against viruses, the only treatment for tonsillitis caused by viral infection is medication to reduce fever and pain. Oral steroids may be given for a short period of time if symptoms are severe. Oral steroids can lessen the symptoms of tonsillitis caused by mononucleosis.
Antibiotics can be helpful in preventing infection if material has collected on the surface of the tonsils. In subacute tonsillitis caused by Actinomyces, penicillin and clindamycin are effective. If these antibiotics do not work, the person can remove the infected material from the tonsil pits with a finger or special irrigating tool. Otherwise, the tonsils should be removed.
In cases of chronic tonsillitis, antibiotics combined with oral steroids may resolve the infection. If not, the tonsils should be removed. Tonsillectomy may be recommended by the healthcare professional if the person has had:
  • more than 6 episodes of tonsillitis in one year

Side Effects

What are the side effects of the treatments?


After Treatment

What happens after treatment for the infection?



How is the infection monitored?


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