The tonsils are two collections of tissue, one on either side of the back of your mouth. They are part of the immune system and act like lymph nodes. They filter out and deal with germs that enter through the nose and mouth. Viruses and bacteria that cause respiratory tract infections can cause the tonsils to become inflamed which is tonsillitis. Sore throat is a symptom and they often become enlarged which makes swallowing difficult.
Tonsillitis is common in childhood. Adults and teenagers can get tonsillitis.
Less commonly and usually in children, tonsillitis can be caused by a specific strain of bacteria, Strep A. Group A Streptococcus will cause a more severe sore throat and inflammation in the surrounding area. See below for more information on Strep A sore throat.
Teenagers are prone to Glandular fever. Tonsillitis with a very sore throat is one of the symptoms. See below for more on glandular fever.
The symptoms of tonsillitis can include:
- sore throat
- pain and difficulty swallowing
- a high temperature
- headache or earache
- white or yellow spots on the tonsils
- cough and other symptoms associated with colds or flu
You can treat the symptoms of tonsillitis yourself. It will usually improve within a few days. Stay hydrated and rest. Painkillers such as paracetamol or ibuprofen will ease the pain and help reduce your temperature. Cool or cold drinks will soothe your sore throat. Avoid sucking or chewing on ice cubes which could damage your teeth or burn the soft tissues of your mouth. Gargling with warm salty water can help. Pelargonium can be used to reduce the severity of symptoms of non-strep A tonsillitis.
Your pharmacist will be able to recommend soothing lozenges or sprays.
Very occasionally the infection of tonsillitis can spread into the tissues round the throat. This is known as a quinsy and is a medical emergency. If you have any of the following symptoms you should call 999 (or 112) or go to A&E (casualty):
- difficulty breathing
- difficulty swallowing
- difficulty speaking (because your tongue or mouth feel restricted)
- swelling of your tongue or throat
- a severe sore throat that is rapidly getting worse
Strep A sore throat
Strep A infection caused by Streptococcus pyrogenes (a Lancefield group A streptococcus). The same bacteria can also cause skin infections and scarlet fever. Most people get a mild infection. It is not known why some people develop more severe infections which can be life threatening. Most infections can be treated with antibiotics.
The symptoms can be similar to those of tonsillitis discussed above but can include:
- sore throat
- enlarged tonsils
- high temperature
- muscle aches
- a skin rash that feels rough (scarlet fever)
- enlarged lymph nodes (glands) in the neck
More information about Strep A infection is available on the NHS website.
Many people have the bacteria that causes Strep A infection living in or on their body and it causes them no problems. The bacteria can be spread very easily by droplets from sneezing, coughing and talking. Droplets that have landed on surfaces or handles that are touched can be spread by then touching the mouth, nose or eyes. You should avoid contact with someone you know is infected and take measures to reduce the spread of the infection (washing hands often, cover nose and mouth when coughing or sneezing etc).
Glandular fever
Glandular fever, also known as kissing disease, is caused by a virus. The medical name for it is infectious mononucleosis and the reason why in some countries it is known as "mono". It is caused by a herpes virus, Epstein-Barr Virus (EBV). In young children it tends to produce a mild flu-like illness or even very few symptoms.
In teenagers and young adults it characteristically comprised of these symptoms:
- High temperature (fever)
- Sore throat (tonsillitis)
- Swollen lymph nodes (glands) in the neck and sometimes elsewhere in the body
Additionally, feeling tired and lethargic is common. This symptom can last for many weeks or even months after the acute infection. It is a well-recognised cause of post-viral fatigue syndrome (also known as chronic fatigue syndrome and myalgic encephalomyelitis, ME).
Headaches and stomach pains also feature for many people. Spleen and liver enlargement can also occur.
Rest and hydration are important. Pain killers like paracetamol and ibuprofen will help reduce temperature and pains.
More information on glandular fever is available on the NHS website.