Understanding Tonsillitis: Causes, Symptoms, and Treatment


Tonsils are a pair of fragile lymph node clusters situated at the back of the throat, one on each side. They serve as the body’s primary defense against invading microorganisms such as bacteria and viruses. Tonsils play a crucial role in combating infections by producing antibodies that neutralize these microorganisms. However, due to this immune function, tonsils are susceptible to infection and inflammation, a condition known as tonsillitis.

Tonsillitis can affect individuals of all age groups, but it is most commonly observed in children and young adults. The relatively rare occurrence of tonsillitis in adults can be attributed to the decline in the immune function of the tonsils after puberty. Typically, tonsillitis resolves on its own with the assistance of prescribed medications. However, in cases where recurrent sore throats, breathing difficulties, or obstructive sleep apnea are linked to infected tonsils, an ENT surgeon may recommend surgical removal.

Scientific research has established that the removal of tonsils in children does not have adverse effects on their immune system. Once removed, tonsils do not regenerate. Nevertheless, if remnants of the tonsils persist in the throat following the surgical procedure, there is an elevated risk of infection and enlargement.

Individuals seeking specialized care for tonsillitis can explore treatment options at Dr. Rao’s ENT, renowned as the best ENT hospital in Hyderabad. Under the expert leadership of renowned surgeon Dr. G V K Chaitanya Rao, this medical facility offers comprehensive and specialized care for tonsillitis and related conditions.

Types of tonsillitis

Types of tonsillitis

There are primarily three types of tonsillitis:

  • Acute tonsillitis – Symptoms of this form usually manifest for 3 or 4 days, although in some cases, they can persist for up to 2 weeks.
  • Recurrent tonsillitis – This condition occurs when an individual experiences multiple episodes of infected tonsils within a year.
  • Chronic tonsillitis – Chronic tonsillitis is characterized by a prolonged period of tonsil infection.

Symptoms of tonsillitis

Individuals experiencing tonsillitis may exhibit the following symptoms:

  • Sore throat
  • Fever
  • Painful swallowing
  • Halitosis (bad breath)
  • Earache
  • Inflamed tonsils
  • Presence of patches on the tonsils
  • Reduced appetite
  • Nausea
  • Fatigue
  • Swollen glands
  • Changes in voice
  • Abdominal discomfort
  • Headache
  • Excessive salivation (drooling)

Is tonsillitis viral or bacterial?

Tonsillitis can have viral or bacterial origins:

Viral tonsillitis – The majority, around 70%, of tonsillitis cases are viral in nature, often stemming from viruses like those responsible for the common cold and influenza (flu).

Bacterial tonsillitis – Bacterial tonsillitis, frequently referred to as strep throat, is caused by the group A streptococcus bacterium. It’s worth noting that individuals without tonsils can still contract strep throat.

Causes of tonsillitis

The factors contributing to tonsillitis can be categorized as follows:

  • Bacterial infection – Such as strep throat
  • Viral infection – Including common cold
  • Viral agents like rhinoviruses and the influenza virus – Associated with the common cold
  • Parainfluenza – Linked to laryngitis and croup
  • Enteroviruses – Responsible for hand, foot, and mouth disease
  • Adenovirus – Associated with diarrhea
  • Rubeola virus – The causative agent of measles
  • Epstein-Barr virus – Connected to glandular fever
  • Herpes simplex virus

Is tonsillitis contagious?

Tonsillitis itself is not a contagious condition. However, the viruses and bacteria responsible for causing tonsillitis are highly contagious. These infections can be transmitted through:

  • Close personal contact or kissing.
  • Sharing utensils, food, or beverages.
  • Being in proximity to an infected individual.
  • Contact with contaminated surfaces.
  • Inhaling small airborne droplets released when an infected person talks, coughs, or sneezes.

What are the risk factors for children?

Tonsillitis primarily impacts children, and the risk factors for this age group include:

Young age – Bacterial tonsillitis is most commonly observed among children aged 5 to 15.

Repeated germ exposure – School-age children, due to their close interactions with classmates, are frequently exposed to viruses and bacteria that can lead to tonsillitis.

Complications of tonsillitis

Complications of tonsillitis

Tonsillitis can lead to the following potential complications:

  • Obstructive sleep apnea
  • Otitis media (Middle ear infection)
  • Scarlet fever
  • Rheumatic fever
  • Tonsillar cellulitis
  • Peritonsillar abscess (Quinsy)
  • Glomerulonephritis

Can tonsillitis resolve naturally?

Tonsillitis typically resolves spontaneously in about a week without the need for antibiotics. Medications recommended by ENT specialists can be utilized to alleviate the symptoms of tonsillitis. Adequate rest and adequate fluid intake are essential, especially if there is a fever.

When is tonsil removal necessary?

Tonsil removal is recommended in the following scenarios:

  • Persistent and frequent episodes of tonsillitis.
  • Difficulty in breathing.
  • Experiencing tonsillitis more than seven times in the last year.
  • Having tonsillitis five times or more in each of the past two years.
  • Suffering from tonsillitis three or more times in each of the past three years.
  • Impaired ability to perform daily activities.
  • Facing sleep-related issues such as snoring, obstructive sleep apnea, sinusitis, ear infections, or dental abnormalities.
  • Complications from infections, such as neck abscess, peritonsillar abscess, rheumatic heart disease, or glomerulonephritis.

Diagnosis of tonsillitis

An ENT specialist identifies tonsillitis through the following methods:

  • Throat examination to observe any redness, swelling, or white patches on the tonsils.
  • Noting other accompanying symptoms such as fever, cough, runny nose, rash, or stomachache.
  • Examination of the ears and nose for additional signs of infection.
  • Evaluation of the neck’s sides to assess the presence of inflamed and tender lymph nodes.

Treatment of tonsillitis

The ENT doctor will prescribe medication based on the underlying cause of the infection. In severe cases, surgical removal of the tonsils, known as tonsillectomy, may be recommended. This procedure typically lasts 20 to 30 minutes and is usually performed under general anesthesia. Surgical methods for tonsil removal include the use of surgical instruments, diathermy, coblation, radiofrequency ablation, CO2 laser, and microdebrider.

After a tonsillectomy, patients may experience side effects such as nausea, pain, earache, stiff neck, difficulty swallowing, changes in voice, and altered taste for a few days. These side effects can be managed with appropriate medication to ensure the patient’s comfort.

In addition to medical treatment, the following home care methods can be beneficial:

  • Get adequate rest.
  • Stay hydrated by consuming enough fluids.
  • Opt for soothing foods and beverages.
  • Practice gargling with saltwater.
  • Use a humidifier to moisten the air.
  • Use lozenges for relief.
  • Take pain and fever medications as directed.
  • Enjoy warm tea with honey.
  • Utilize throat sprays as recommended.
  • Avoid irritants and refrain from straining the voice.

How to prevent tonsillitis?

Tonsillitis can be prevented by adhering to these guidelines:

  • Ensure thorough hand washing practices.
  • Refrain from sharing food, glasses, water bottles, or utensils.
  • Replace your toothbrush if you’ve been diagnosed with tonsillitis.
  • Keep unwell children at home.
  • By following these recommendations, the risk of tonsillitis can be minimized effectively.

When to consult a doctor?

Seek medical attention if you experience the following symptoms:

  • Sore throat accompanied by a high fever.
  • Pain or difficulty when swallowing.
  • Unusual weakness or fatigue.
  • Breathing difficulties.
  • Severe drooling.
  • In such cases, it is advisable to consult a healthcare professional promptly.


In summary, Dr. Rao’s ENT stands at the forefront of healthcare excellence in the domain of ear, nose, and throat care. With an unswerving dedication to delivering top-tier medical services and guided by the expertise of esteemed surgeons like Dr. G V K Chaitanya Rao, our hospital has earned the trust and respect of the Hyderabad community.

For those seeking relief from the challenges posed by tonsillitis, the journey towards improved throat health begins right here. There’s no need to endure the discomfort and recurrent infections associated with tonsillitis any longer.

Dr. Rao’s ENT warmly invites individuals to schedule their appointments today, taking that crucial first step towards a life free from the inconveniences of tonsillitis. Our committed team is fully prepared to provide expert guidance and unwavering support throughout every phase of your healthcare journey. Your well-being remains our unwavering priority.

About the author

Best ent doctor hyderabad | Dr.GVK Chaitanya Rao

Dr. Chaitanya Rao, Managing director at Dr. Rao’s ENT group of hospitals has 10 years experience in the field of ENT.

His special areas of interest include Nose & sinus surgeries, Otology, Snoring and sleep apnea surgeries. During his Post-graduation itself he was invited as a visiting physician to House Institute of Medical sciences, Los Angeles; Rhinology and Anterior skull base unit, Ohio State University Medical Centre, Columbus, Ohio and University of Michigan from where he picked up his skills.

He plays a key role (Course Director & co-ordinator) in giving hands on training to around 150 ENT surgeons every year from all around the world for initiating and improving their ENT surgical skills as a part of Hyderabad ENT Research Foundation initiatives.

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