What is acute tonsillitis?
Acute tonsillitis is a sudden inflammation of the tonsils, usually accompanied by a sore throat, fever and difficulty swallowing. The condition is most common in children, but it also affects adults.
Causes (aetiology)
Acute tonsillitis is caused by viral or bacterial infections:
- Viral: adenovirus, rhinovirus, enterovirus, Epstein-Barr virus (mononucleosis), influenza and others.
- Bacterial: most often Streptococcus pyogenes (group A beta-haemolytic streptococcus), although other bacteria may also be involved.
The most common symptoms
- Severe throat pain, often on one side
- High fever (up to 39–40°C)
- Difficulty and pain when swallowing
- Red, swollen tonsils, often covered with a white exudate
- Bad breath
- Enlarged lymph nodes in the neck
- In some cases: ear pain (referred pain)
How is it diagnosed?
- The doctor examines the throat and the tonsils
- In some cases a rapid streptococcal test (strep test) or a throat culture is recommended to identify the bacterium
How is acute tonsillitis treated?
Treatment depends on the cause:
- Viral: symptomatic treatment is sufficient – pain relief (paracetamol, ibuprofen), warm fluids, rest and gargling with salt water or antiseptic solutions.
- Bacterial: an antibiotic is required, usually penicillin V or amoxicillin, for 7–10 days. In case of allergy, azithromycin or clindamycin is used.
Important Inadequate treatment of bacterial infections can lead to serious complications such as:
- Peritonsillar abscess (a collection of pus around the tonsil)
- Acute rheumatic fever (which can damage the heart)
- Post-streptococcal glomerulonephritis (kidney damage)
When should you see a doctor?
- Severe pain that does not improve within 3–4 days
- Difficulty opening the mouth
- Breathing problems
- High fever that does not respond to medication
👉 Practical advice: Do not take antibiotics without a prescription. Not every sore throat requires an antibiotic – unnecessary use can harm the body and lead to bacterial resistance.