Acute Tonsillitis / Pharyngitis Quiz
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Sore throat
Fatigued
Have a fever
Swallowing difficulties
White spots at the back of the throat
Pain when swallowing
Swollen tonsils
Not seeing your symptoms? No worries!
What is Acute Tonsillitis / Pharyngitis?
Infection of the tonsils and pharynx (back of the mouth), either by viruses or bacteria.
Typical Symptoms of Acute Tonsillitis / Pharyngitis
- Unable to swallow liquids
- Discharge of yellow or green sputum.
- Swollen throat
- Pain at the back of the head
- Sore throat with pain when swallowing
- Recurrent fever episodes
- Cough worsens after exercise
- Whole body pain
Diagnostic Questions for Acute Tonsillitis / Pharyngitis
Your doctor may ask these questions to check for this disease:
- Are you unable to swallow liquids?
- Do you have yellow or green sputum?
- Is your throat swollen?
- Do you have pain at the back of your head?
- Do you have a sore throat with pain when swallowing?
Treatment of Acute Tonsillitis / Pharyngitis
This condition may improve without treatment, especially if caused by viruses. The doctor may prescribe pain relievers, and in some cases antibiotics to fight a bacterial infection. Ensuring proper hydration is important as pain makes swallowing and drinking difficult.
Reviewed By:
Scott Nass, MD, MPA, FAAFP, AAHIVS (Primary Care)
Dr. Nass received dual medical degrees from the David Geffen School of Medicine at UCLA and Charles R. Drew University in Medicine and Science. He completed Family Medicine residency at Ventura County Medical Center with subsequent fellowships at Ventura, University of North Carolina-Chapel Hill, George Washington University, and University of California-Irvine. He holds faculty appointments at Keck School of Medicine of USC, Loma Linda University School of Medicine, and Western University of Health Sciences.
Rohini R, MD (Otolaryngology (ENT))
Dr. Rohini R is an ENT, Head and Neck Surgeon, with a Fellowship in Advanced Endoscopic Sinus and Skull Base Surgery and a Fellowship in Aesthetic Medicine and Lasers. Besides clinical practice and working with Ubie, she is actively training and mentoring medical students and residents. She has functioned in various work settings - teaching hospitals, private and free health centers, and worked with patients from all socioeconomic backgrounds due to her experience in free hospitals and volunteering in India and Singapore.
Content updated on Feb 13, 2025
Following the Medical Content Editorial Policy
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People with similar symptoms also use Ubie's symptom checker to find possible causes
- Throat swelling
- One side of the throat is swollen
- Hard to eat
- Difficult to swallow food because of pain
- Asymmetric throat swelling
- Tonsils are inflamed
- Throat feels burnt when I drink
- Unilateral tonsillar swelling
- Throat tightness
- Swelling of the throat is worse on one side
- Bump in the throat
- Swollen uvula
- Sore, swollen glands in neck or jaw
See full list
Symptoms Related to Acute Tonsillitis / Pharyngitis
Diseases Related to Acute Tonsillitis / Pharyngitis
FAQs
Q.
Throat Still Sore? Why Remedies Fail & Medically Approved Next Steps
A.
If your sore throat persists after tea, lozenges, and pain relievers, it may be strep, allergies with postnasal drip, acid reflux, irritants, or a viral illness that can last up to 10 days; the approved next steps are to reassess symptoms, consider strep testing, and treat the underlying cause while watching for red flags like breathing or swallowing trouble, high fever, rash, or one-sided swelling. There are several factors to consider. See below for the full checklist, evidence-based remedies, and exact thresholds for testing and urgent care.
References:
* Rosenfeld, R. M., et al. (2017). Clinical practice guideline: adult sore throat. *Otolaryngology--Head and Neck Surgery*, *157*(1_suppl), S1-S37. PMID: 28892110.
* Piskovatska, V., et al. (2017). Chronic pharyngitis: causes, diagnosis and treatment. *Current Opinion in Otolaryngology & Head and Neck Surgery*, *25*(2), 164-169. PMID: 28406859.
* Schachtel, B. P., & Schachtel, E. P. (2015). Symptomatic treatment of acute pharyngitis: a review of the evidence. *Expert Review of Anti-infective Therapy*, *13*(2), 239-247. PMID: 25686000.
* Ginde, A. A., et al. (2015). Diagnosis and management of viral pharyngitis in the emergency department. *Journal of Emergency Medicine*, *48*(1), 127-133. PMID: 25529462.
* Kim, Y. H., et al. (2018). Evaluation of the patient with chronic throat pain. *Otolaryngologic Clinics of North America*, *51*(3), 643-655. PMID: 29991586.
Q.
Persistent Pain? Why Your Pharynx is Inflamed & Medically Approved Next Steps
A.
Persistent throat pain often points to inflammation of the pharynx from common causes like viral infections, strep, tonsillitis, allergies, acid reflux, or irritants, with less common but serious problems possible. Medically approved next steps are to monitor and use supportive care if mild, get evaluated and tested if symptoms last more than 10 days or worsen, and seek urgent care for red flags such as trouble breathing, drooling, severe one-sided pain, high fever, or a muffled voice; there are several factors to consider, and vital details that could change your plan are explained below.
References:
* Liu Y, Zhang Z, Jiang W, et al. Chronic Pharyngitis: Current Perspectives on Diagnosis and Management. Clin Rev Allergy Immunol. 2022 Dec;63(3):399-410. doi: 10.1007/s12016-022-08945-8. Epub 2022 Oct 13. PMID: 36229562.
* Lechien JR, Akoumianakis D, Karkos P, et al. Global Consensus on Laryngopharyngeal Reflux: A Literature Review of Symptoms, Diagnostic Modalities, and Management. Otolaryngol Head Neck Surg. 2023 Dec;169(6):1494-1506. doi: 10.1177/01945998231187474. Epub 2023 Jun 28. PMID: 37376678.
* Bhargava SD, Agrawal V, Bhatia S, Soni N. Chronic pharyngitis: a review of current concepts in etiology and management. Eur Rev Med Pharmacol Sci. 2018 Oct;22(20):6893-6902. doi: 10.26355/eurrev_201810_16231. PMID: 30379201.
* Al-Hussona MZ, Hamad MA, Al-Muzaini AM. The Correlation between Allergic Rhinitis and Chronic Pharyngitis. J Family Med Prim Care. 2020 Jul 30;9(7):3585-3589. doi: 10.4103/jfmpc.jfmpc_252_20. PMID: 33042784; PMCID: PMC7567702.
* Lee JS, Cha DH, Kim KM, et al. Chronic throat discomfort: what is it and how do we treat it? Clin Exp Otorhinolaryngol. 2011 Sep;4(3):109-17. doi: 10.3342/ceo.2011.4.3.109. Epub 2011 Sep 12. PMID: 21949575; PMCID: PMC3171888.
Q.
Pharyngitis? Why Your Throat Is Inflamed & Medically Approved Next Steps
A.
Pharyngitis is throat inflammation that most often comes from viruses and improves in 5 to 7 days with supportive care; bacterial strep is less common, requires testing, and antibiotics can speed recovery within 24 to 48 hours. Get urgent care for trouble breathing, drooling, a muffled voice, severe neck swelling, inability to swallow saliva, or a high fever that does not improve. There are several factors to consider, including symptoms pointing to strep vs viral causes, when to test, which treatments help, and prevention; see the complete details below to choose the right next steps.
References:
* Shulman ST, Bisno AL, Clegg HW Jr, Gerber MA, Kaplan EL, Lee G, Van Beneden JA. Clinical Practice Guideline for the Diagnosis and Management of Group A Streptococcal Pharyngitis: 2012 Update by the Infectious Diseases Society of America. Clin Infect Dis. 2012 Nov 15;55(10):e86-109.
* Tanz RR. Streptococcal Pharyngitis: Epidemiology, Clinical Manifestations, Diagnosis, and Management. Infect Dis Clin North Am. 2021 Mar;35(1):1-16.
* Choby BA. Update on the Diagnosis and Management of Group A Streptococcal Pharyngitis. Am Fam Physician. 2020 Jul 15;102(2):98-103.
* Pelucchi C, Grigoryan L, Galeone S, Esposito S, Huovinen P, Little P, Verheij T. Approach to the diagnosis and management of viral pharyngitis. New Microbiol. 2018 Jan;41(1):1-5.
* Little P, Moore M. Pathogenesis, diagnosis, and management of acute pharyngitis. BMJ. 2018 Sep 26;362:k3839. doi: 10.1136/bmj.k3839. PMID: 30257850.
Q.
Swallowing Glass? Why Your Throat Is Under Attack & Your Strep Relief Plan
A.
A sharp “swallowing glass” sore throat is often strep, a bacterial infection that needs a rapid test and antibiotics; key clues are sudden severe pain, fever, swollen tender neck nodes, red swollen tonsils with white patches, and usually no cough. Testing is the only way to know for sure. Relief and safety depend on the right steps: take the full antibiotic course if prescribed, use acetaminophen or ibuprofen and soothing fluids, stay home until 24 hours after starting treatment, and seek urgent care for trouble breathing or swallowing, high fever, or one-sided severe swelling. There are several factors to consider, and important details that could change your next steps are explained below.
References:
* Chiappini, E., Bortone, B., Tovo, P. A., et al. (2018). Acute pharyngitis: a practical guide to diagnosis and treatment. *Italian Journal of Pediatrics, 44*(Suppl 2), 114.
* Shulman, S. T., & Bisno, A. L. (2020). Diagnosis and Management of Group A Streptococcal Pharyngitis: A 2020 Update. *Current Infectious Disease Reports, 22*(12), 40.
* Carapetis, J. R., Beaton, A., & O'Connor, G. M. (2019). Acute Rheumatic Fever in the 21st Century: Clinical, Pathogenetic, and Public Health Considerations. *Circulation, 139*(20), 2376-2391.
* Gerber, M. A. (2016). Revisiting antibiotic treatment of streptococcal pharyngitis. *The Pediatric Infectious Disease Journal, 35*(11), 1259-1260.
* Popovich, E., Coyle, D., & Salter, J. (2017). Non-antibiotic treatments for sore throat: a systematic review. *Family Practice, 34*(3), 260-267.
Q.
Can kissing or sharing utensils spread tonsillitis?
A.
Yes, kissing or sharing utensils can spread tonsillitis, as it can be caused by infections like the Epstein-Barr virus, which spreads through saliva.
References:
Dunmire SK, Verghese PS, & Balfour HH Jr. (2018). Primary Epstein-Barr virus infection. Journal of clinical virology : the official publication of the Pan American Society for Clinical Virology, 29525635.
https://pubmed.ncbi.nlm.nih.gov/29525635/
Watanabe Y, Sato A, Nakamura I, & Watanabe H. (2021). Case of sexually transmitted recurrent pharyngotonsillitis .... Sexually transmitted infections, 33328193.
https://pubmed.ncbi.nlm.nih.gov/33328193/
Shine N, Konopka K, & Düzgüneş N. (1997). The anti-HIV-1 activity associated with saliva - PubMed - NIH. Journal of dental research, 9062556.
Q.
Can you catch tonsillitis from someone who has a sore throat?
A.
Yes, you can catch tonsillitis from someone with a sore throat if it is caused by an infection that spreads easily, like certain bacteria or viruses.
References:
Schöfer H. (2012). [Sexually transmitted infections of the oral cavity]. Der Hautarzt; Zeitschrift fur Dermatologie, Venerologie, und verwandte Gebiete, 22895675.
https://pubmed.ncbi.nlm.nih.gov/22895675/
Ogawa H, Hashiguchi K, & Kazuyama Y. (1993). Prolonged and recurrent tonsillitis associated with sexually .... The Journal of laryngology and otology, 8445306.
https://pubmed.ncbi.nlm.nih.gov/8445306/
Esposito S, Bosis S, Begliatti E, Droghetti R, Tremolati E, Tagliabue C, et al. (2006). Acute tonsillopharyngitis associated with atypical bacterial .... Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 16779748.
Q.
Can you go to work or school if you have tonsillitis?
A.
If you have tonsillitis, it's best to stay home from work or school because you might spread germs to others and need rest to get better.
References:
Wilson JA, Fouweather T, Stocken DD, Homer T, Haighton C, Rousseau N, et al. (2023). the NATTINA RCT and economic evaluation. Health technology assessment (Winchester, England), 38204203.
https://pubmed.ncbi.nlm.nih.gov/38204203/
Tartari E, Saris K, Kenters N, Marimuthu K, Widmer A, Collignon P, et al. (2020). Not sick enough to worry? "Influenza-like" symptoms and .... PloS one, 32401751.
https://pubmed.ncbi.nlm.nih.gov/32401751/
Kontos A, Lushington K, Martin J, Schwarz Q, Green R, Wabnitz D, et al. (2017). Relationship between Vascular Resistance and .... Journal of the American Heart Association, 28716800.
Q.
How can you prevent spreading tonsillitis to your family?
A.
To prevent spreading tonsillitis, practice good hygiene like washing hands frequently and avoid sharing personal items.
References:
Brook I, & Dohar JE. (2006). Management of group A beta-hemolytic streptococcal .... The Journal of family practice, 17137534.
https://pubmed.ncbi.nlm.nih.gov/17137534/
Abuelgasim H, Albury C, & Lee J. (2021). Effectiveness of honey for symptomatic relief in upper .... BMJ evidence-based medicine, 32817011.
https://pubmed.ncbi.nlm.nih.gov/32817011/
Hoare S. (2003). HIV infection in children--impact upon ENT doctors. International journal of pediatric otorhinolaryngology, 14662174.
Q.
Is tonsillitis contagious, and how long does it stay contagious?
A.
Tonsillitis can be contagious, especially if caused by a bacterial or viral infection, and it may remain contagious for several days, depending on the cause.
References:
Casey JR, & Pichichero ME. (2005). Higher dosages of azithromycin are more effective in .... Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 15909262.
https://pubmed.ncbi.nlm.nih.gov/15909262/
Dalalah D, & Magableh S. (2008). A remote fuzzy multicriteria diagnosis of sore throat. Telemedicine journal and e-health : the official journal of the American Telemedicine Association, 18817494.
https://pubmed.ncbi.nlm.nih.gov/18817494/
Dunmire SK, Hogquist KA, & Balfour HH. (2015). Infectious Mononucleosis - PubMed - NIH. Current topics in microbiology and immunology, 26424648.
Q.
When should you see a doctor for recurrent or severe tonsillitis?
A.
You should see a doctor for recurrent or severe tonsillitis if you have frequent sore throats, difficulty breathing, or if the condition does not improve with usual treatments.
References:
Stelter K. (2014). Tonsillitis and sore throat in children. GMS current topics in otorhinolaryngology, head and neck surgery, 25587367.
https://pubmed.ncbi.nlm.nih.gov/25587367/
Stelter K. (2014). [Tonsillitis and sore throat in childhood]. Laryngo- rhino- otologie, 24710788.
https://pubmed.ncbi.nlm.nih.gov/24710788/
Powell J, O'Hara J, Carrie S, & Wilson JA. (2017). Is Tonsillectomy Recommended in Adults With Recurrent .... BMJ (Clinical research ed.), 28408369.
Q.
What should I do if my tonsillitis symptoms haven't improved after 4 days?
A.
If your tonsillitis symptoms have not improved after four days, it is important to seek medical attention. Persistent symptoms may indicate a more serious infection or the need for a different treatment approach.
References:
Georgalas CC, Tolley NS, Narula PA. Tonsillitis. BMJ Clin Evid. 2014 Jul 22;2014:0503. PMID: 25051184; PMCID: PMC4106232.
Singh H, Bhatt A, Kumar M, Deshmukh P. Tonsillitis and Sinusitis: A Narrative Review of Pathogenesis, Diagnosis, and Management. Cureus. 2023 Oct 17;15(10):e47192. doi: 10.7759/cureus.47192. PMID: 38021555; PMCID: PMC10652663.
Q.
What causes tonsils to swell?
A.
Tonsils can swell due to various causes, primarily infections and other inflammatory conditions. Understanding these causes can help in managing symptoms and determining the appropriate treatment.
References:
InformedHealth.org [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. Overview: Enlarged tonsils and adenoids. [Updated 2023 Jan 17].
Q.
Can stress cause one tonsil to swell?
A.
Stress can potentially contribute to the swelling of one tonsil, although it is not a direct cause. Unilateral tonsillar enlargement is often associated with infections or other medical conditions, but stress may exacerbate underlying issues or affect the immune response, leading to tonsil swelling.
References:
Cortez EA, Mattox DE, Holt GR, Gates GA. Unilateral tonsillar enlargement. Otolaryngol Head Neck Surg (1979). 1979 Nov-Dec;87(6):707-16. doi: 10.1177/019459987908700603. PMID: 530694.
Alicandri-Ciufelli M, Molteni G, Villari D, Mattioli F, Presutti L. Tonsillar swelling: always a simple diagnosis? Med J Aust. 2009 Apr 20;190(8):457. doi: 10.5694/j.1326-5377.2009.tb02502.x. PMID: 19374623.
Cvetković T, Vlahović P, Todorović M, Stanković M. Investigation of oxidative stress in patients with chronic tonsillitis. Auris Nasus Larynx. 2009 Jun;36(3):340-4. doi: 10.1016/j.anl.2008.10.004. Epub 2008 Dec 25. PMID: 19111415.
Q.
How long is tonsillitis contagious, and how long should you take off from work or school?
A.
Tonsillitis can be contagious, especially if it is caused by a viral or bacterial infection. Generally, individuals with tonsillitis should stay home from work or school until they have been on antibiotics for at least 24 hours if the cause is bacterial, or until symptoms improve if it is viral.
References:
Windfuhr, J.P., Toepfner, N., Steffen, G. _et al._ Clinical practice guideline: tonsillitis I. Diagnostics and nonsurgical management. _Eur Arch Otorhinolaryngol_ 273, 973–987 (2016). https://doi.org/10.1007/s00405-015-3872-6
KidsHealth. (n.d.). _Tonsillitis_. Nemours Children’s Health. Retrieved December 19, 2024, from
https://kidshealth.org/en/teens/tonsillitis.html
Schwartz RH, Kim D, Martin M, Pichichero ME. A Reappraisal of the Minimum Duration of Antibiotic Treatment Before Approval of Return to School for Children With Streptococcal Pharyngitis. Pediatr Infect Dis J. 2015 Dec;34(12):1302-4. doi: 10.1097/INF.0000000000000883. PMID: 26295745.
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Buettner, R., Schwermer, M., & Ostermann, T. (2023). Complementary and alternative medicine in the (symptomatic) treatment of acute tonsillitis in children: A systematic review. Therapies in Medicine.
https://www.sciencedirect.com/science/article/pii/S0965229923000274Bochner, R. E., Gangar, M., & Belamarich, P. F. (2017). A clinical approach to tonsillitis, tonsillar hypertrophy, and peritonsillar and retropharyngeal abscesses. Pediatrics in Review.
https://publications.aap.org/pediatricsinreview/article-abstract/38/2/81/31836Eroğlu, A., Suzan, Ö. K., Kolukısa, T., & Kaya, Ö. (2024). The relationship between group A streptococcus test positivity and clinical findings in tonsillopharyngitis in children: systematic review and meta-analysis. Infection.
https://link.springer.com/article/10.1007/s15010-024-02395-7