Swollen Tonsils? Why Your Throat Is Inflamed & Medical Next Steps

Swollen tonsils are one of the most common reasons people develop a sore throat. Whether you're dealing with painful swallowing, fever, or swollen glands, inflamed tonsils can make even simple tasks like eating and talking uncomfortable.

The good news? Most cases are treatable and resolve without long-term problems. But in some situations, swollen tonsils can signal something more serious that needs medical attention.

Here's what you need to know about why your tonsils are swollen, what symptoms to watch for, and when to seek care.

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What Are Tonsils?

Your tonsils are two oval-shaped pads of tissue located at the back of your throat. They're part of your immune system and help trap germs that enter through your mouth or nose.

Because they are constantly exposed to viruses and bacteria, the tonsils can become infected or inflamed. This condition is commonly called tonsillitis.

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Why Are My Tonsils Swollen?

Swollen tonsils usually happen because of an infection. The most common causes include:

1. Viral Infections (Most Common)

Viruses cause the majority of sore throats and swollen tonsils. Examples include:

• Common cold viruses
• Influenza (flu)
• COVID-19
• Epstein-Barr virus (mono)

Viral tonsillitis typically improves within 5–10 days with rest and supportive care.

2. Bacterial Infections

The most well-known bacterial cause is Group A Streptococcus, often called "strep throat."

Strep throat is more common in children but can affect adults. Unlike viral infections, bacterial infections may require antibiotics.

3. Chronic or Recurrent Tonsillitis

Some people experience frequent infections. Chronic inflammation can cause:

• Ongoing swelling
• Persistent bad breath
• Repeated sore throats

4. Peritonsillar Abscess (Serious but Less Common)

In rare cases, infection spreads and forms a pocket of pus beside the tonsil. This is a medical emergency and requires urgent care.

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Common Symptoms of Swollen Tonsils

Inflamed tonsils often cause noticeable symptoms. These may include:

• Sore throat
• Pain with swallowing
• Red, enlarged tonsils
• White or yellow patches on the tonsils
• Fever
• Swollen lymph nodes in the neck
• Hoarse or muffled voice
• Headache
• Fatigue

In children, you might also notice:

• Drooling
• Refusal to eat
• Irritability
• Stomach pain (common with strep)

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Viral vs. Bacterial: How to Tell the Difference?

It can be difficult to tell whether swollen tonsils are caused by a virus or bacteria without testing. However, some patterns can help:

Viral Tonsillitis Often Includes:

• Cough
• Runny nose
• Hoarseness
• Mild fever

Strep Throat Often Includes:

• Sudden sore throat
• Fever over 101°F (38.3°C)
• No cough
• White patches on tonsils
• Swollen, tender neck glands

A healthcare provider may perform a rapid strep test or throat culture to confirm bacterial infection.

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At-Home Care for Swollen Tonsils

If your symptoms are mild and you suspect a viral cause, supportive care can help you recover comfortably:

• Rest
• Drink warm fluids (tea, broth)
• Stay hydrated
• Gargle with warm salt water
• Use throat lozenges (for adults and older children)
• Take over-the-counter pain relievers like acetaminophen or ibuprofen (as directed)

Most viral infections improve within a week.

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When Should You See a Doctor?

While many cases of swollen tonsils are mild, some symptoms require medical evaluation.

See a healthcare provider if you experience:

• Fever above 101°F lasting more than 2–3 days
• Severe throat pain
• Difficulty swallowing liquids
• Trouble breathing
• Drooling (especially in children)
• One tonsil much larger than the other
• Symptoms lasting longer than 10 days
• Repeated episodes of tonsillitis

If you're experiencing throat pain and swelling but aren't sure whether it requires medical attention, try using this free Acute Tonsillitis / Pharyngitis symptom checker to help identify what might be causing your symptoms and whether you should seek care.

However, online tools are not a replacement for medical care.

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Emergency Warning Signs

Seek immediate medical care or go to the emergency room if you notice:

• Difficulty breathing
• Inability to swallow saliva
• Severe neck swelling
• Muffled or "hot potato" voice
• High fever with severe illness
• Signs of dehydration

These could indicate a serious infection such as a peritonsillar abscess or airway obstruction. These situations are uncommon, but they can become life-threatening if untreated.

Always speak to a doctor immediately about symptoms that feel severe, rapidly worsening, or life-threatening.

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Treatment Options

Treatment depends on the cause.

For Viral Tonsillitis

• No antibiotics needed
• Supportive care
• Symptoms typically improve within 7–10 days

For Strep Throat

• Antibiotics (commonly penicillin or amoxicillin)
• Most people feel better within 1–3 days of starting treatment
• Important to complete the full course

Treating strep throat reduces the risk of complications such as:

• Rheumatic fever
• Kidney inflammation
• Spread of infection

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What About Tonsil Removal (Tonsillectomy)?

In some cases, doctors may recommend removing the tonsils. This is more common in children but can be done in adults.

Reasons may include:

• 7 or more infections in one year
• 5 infections per year for 2 consecutive years
• 3 infections per year for 3 years
• Sleep-disordered breathing due to enlarged tonsils
• Recurrent abscess

Tonsillectomy is generally safe but does involve recovery time and surgical risks. A doctor can help determine if it's appropriate.

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Can Swollen Tonsils Be Prevented?

You can't completely prevent infections, but you can reduce risk:

• Wash hands frequently
• Avoid sharing utensils or drinks
• Replace toothbrush after strep infection
• Stay current with recommended vaccines
• Avoid close contact with sick individuals

If you experience frequent infections, discussing long-term management with a healthcare provider is important.

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The Bottom Line

Swollen tonsils are usually caused by viral or bacterial infections. Most cases improve with rest and simple treatments. However, some infections—particularly strep throat or abscesses—require medical care.

Pay attention to:

• Fever severity
• Difficulty swallowing or breathing
• Duration of symptoms
• Recurring infections

If you're unsure what's causing your symptoms, consider using a free online Acute Tonsillitis / Pharyngitis symptom checker to help guide your next steps. Still, any concerning or severe symptoms should prompt you to speak directly with a healthcare professional.

Your throat discomfort may be temporary—but your health is worth careful attention. If something feels serious, worsening, or life-threatening, speak to a doctor immediately.