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A sore throat is often the first sign of a cold and may get better after a day or two; other cold symptoms such as a runny nose and congestion may follow the sore throat. The primary symptom of tonsillitis is a moderate to severe sore throat lasting longer than 2 days and involves inflammation of the tonsils. Other symptoms of tonsillitis may include:

  • Difficult or painful swallowing
  • Laryngitis
  • Swollen and tender glands (lymph nodes) on the sides of the neck
  • Bad breath
  • Fever and chills
  • Tiredness, headacheearache
  • Stomach upset or pain
  • Enlarged and reddened tonsils with spots of white/yellow pus
  • Mouth breathing, noisy breathing, and/or snoring (due to enlarged tonsils blocking the airways).

Symptoms of tonsillitis usually resolve after three to four days but may last up to two weeks, even with treatment.


The majority of tonsillitis cases are caused by viruses, with only 15 - 30% of cases caused by bacteria.
Many different types of virus can cause viral tonsillitis but the cold virus is the most common cause. The Epstein-Barr virus, which is responsible for glandular fever, the measles virus and cytomegalovirus can also cause tonsillitis.  Most cases of bacterial tonsillitis are associated with a bacterium called Streptococcus pyogenes, which is the most common cause of strep throat.

Tonsillitis caused by Streptococcus pyogenes is highly contagious and tonsillitis caused by the Epstein-Barr virus is contagious the first time a person has it. In both cases, steps to prevent its spread should be taken.

More about Treatment

Tonsillitis is inflammation of the tonsils caused by bacterial or viral infection. Typical symptoms are sore throat, swollen tonsils, difficulty swallowing, fever, and swollen glands in the neck. Treatment will differ depending on whether the cause is bacterial or viral. Surgical removal of the tonsils (tonsillectomy) may be recommended in some cases.

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