Tonsillitis refers to inflammation of the tonsils—the two soft masses of tissue located at the back of the throat. The condition typically develops suddenly and causes symptoms such as sore throat, fever, and swollen or red tonsils. It most often affects children over the age of two and teenagers, while it is relatively uncommon in adults.

Most cases of tonsillitis are acute, meaning the symptoms are short-term and clear up either with treatment or on their own. However, some individuals experience recurrent tonsillitis—defined as five or more episodes in a year—or chronic tonsillitis, which lasts longer than three months. Recognizing the symptoms is key to identifying the type of tonsillitis and understanding when to seek medical care.

Common Symptoms

Symptoms of acute tonsillitis typically resolve within three to four days. In the early stages of both recurrent and chronic tonsillitis, symptoms tend to mirror those of acute cases.

common signs include

  • Fever over 38°C (100.4°F)

  • Intense sore throat

  • Red, swollen tonsils

  • White or yellow patches on the tonsils

  • Difficulty swallowing (dysphagia)

  • Pain when swallowing (odynophagia)

  • Pain radiating to the ears

Less Common Symptoms

In more advanced or chronic cases of tonsillitis, additional symptoms may occur beyond the common ones.

less frequent signs may include

  • Persistent bad breath (halitosis)

  • Swollen and tender lymph nodes

  • Creamy, pus-filled sacs on the tonsils

  • Formation of tonsil stones (hard, calcified lumps)

Rare Symptoms

In rare situations, the infection from tonsillitis may spread beyond the tonsils and result in serious complications. These issues are more likely in individuals with chronic or recurrent tonsillitis and may require surgical treatment.

Peritonsillar Abscesses

Peritonsillar abscesses are pockets of pus that form in the tissues surrounding the tonsils. This complication may cause a range of intense symptoms.

possible symptoms include

  • Intense sore throat

  • Bad breath

  • Inability to open the mouth fully (lockjaw)

  • Severe fatigue

  • Hoarseness

  • Noticeable swelling and redness of the tonsils

  • Ear pain

Rheumatic Fever

Tonsillitis caused by certain bacteria, such as group A streptococcus, can lead to rheumatic fever. This condition affects the joints, heart, and brain and may result in long-term health issues.

symptoms to watch for

  • Swelling and pain in the joints

  • Small bumps or nodules under the skin

  • Shortness of breath

  • Muscle control issues in the face, arms, or legs

  • Chest pain

  • Swelling in the hands, feet, or abdomen

  • Abnormal heart sounds (heart murmur)

Glomerulonephritis

In some cases, tonsillitis can trigger glomerulonephritis—an inflammatory condition that affects the kidney’s ability to filter waste and fluids. While it may not always cause symptoms, some individuals experience noticeable signs.

potential symptoms include

  • Skin rash

  • Painful joints

  • Abdominal discomfort

  • Fatigue and fever

  • Shortness of breath

  • Yellowing of the skin or eyes (jaundice)

  • Difficulty urinating

  • Poor appetite

  • High blood pressure

Lemierre Syndrome

Lemierre syndrome is a serious and potentially life-threatening complication. It occurs when the infection spreads to the neck and bloodstream, leading to the formation of blood clots in organs such as the lungs, brain, and liver.

serious symptoms of LS include

  • High fever

  • Significant swelling of the lymph nodes

  • Stiffness or swelling in the neck

  • Headaches and fatigue

  • Chills and sore throat

  • Pain when swallowing

  • Cough and shortness of breath

  • Abdominal or joint pain

  • Dental or ear discomfort

When To See a Healthcare Provider

Although acute tonsillitis often improves within a few days, knowing when to contact a healthcare provider is essential. Early intervention can help prevent complications and reduce discomfort.

you should call a provider if

  • A sore throat persists for more than three days

  • There is pain during swallowing

  • Symptoms are severe, such as high fever or extreme fatigue

seek emergency care if you notice

  • Difficulty breathing

  • Excessive drooling in a child or infant

  • Inability to swallow food or water

  • Jaundice

  • Dangerously high fever

A Quick Review

Tonsillitis is an infection of the tonsils that most commonly affects children and teenagers. While symptoms like sore throat, fever, and red or swollen tonsils are common, the condition may also lead to serious complications in some cases.

Most people recover from acute tonsillitis without medical intervention. However, recurrent or chronic cases increase the risk of complications such as abscesses, kidney inflammation, or rheumatic fever. If symptoms worsen or interfere with breathing or swallowing, it’s important to seek medical attention to avoid severe health risks.