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Published on: 8/18/2026

What could cause unilateral tonsil swelling accompanied by pain?

One-sided tonsil swelling with pain is often caused by infections like tonsillitis, peritonsillar abscess, or less commonly, primary syphilis. Because unilateral tonsil enlargement can also signal rarer conditions, prompt medical evaluation is essential for accurate diagnosis and treatment.

If you're experiencing swelling on one side of your throat, don't guess at the cause or wait for it to worsen. Identifying the source early can prevent complications and guide you toward the right care. Take a free, instant, online symptom check to better understand your symptoms and confidently navigate your next steps.

Reviewed for medical accuracy: 07/20/2026

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Explanation

Unilateral tonsil swelling, which means only one tonsil is enlarged, can be caused by various conditions. According to the medical literature, one possible cause is an infection. For example, Reference 3 discusses a case where primary syphilis led to unilateral tonsillitis, causing one tonsil to swell and become painful. This shows that infections, even those that are not commonly associated with the tonsils, can cause this condition.

Another cause of unilateral tonsil swelling mentioned in Reference 2 is an unusual condition, which implies that there are less common or rare reasons for this symptom. Reference 1 also highlights the importance of considering different causes for unilateral tonsillar enlargement, suggesting that a thorough medical evaluation is necessary to identify the exact cause.

In summary, if someone experiences swelling and pain in one tonsil, it is important to seek medical attention to determine the underlying cause and receive appropriate treatment. You can start by taking a free AI symptom checker assessment to help identify potential causes of your symptoms before consulting with a healthcare provider.

(References)

  • Cortez EA, Mattox DE, Holt GR, & Gates GA. (1979). Unilateral tonsillar enlargement. Otolaryngology and head and neck surgery, 530694.

  • Kizhner V, Segal Y, Karam M, Zohar S, & Gilbey P. (2008). an unusual cause of unilateral tonsillar enlargement. Harefuah, 19039902.

  • Taniguchi T, Yamamoto M, Miyoshi S, & Shimizu S. (2024). Unilateral tonsillitis due to primary syphilis with gram- .... BMJ case reports, 38367986.

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