Tonsillitis (bacterial, viral, acute, chronic): what is it?


What is tonsillitis?

Tonsillitis, also known as tonsillitis, is the infection of the tonsils, which can be caused by several other infections. Tonsils are lymphoid tissues, that is, they are part of the immune system, helping to protect the body. They are located in the anterior region of the throat.

Altogether, there are four tonsils. However, with the naked eye, you can only see two: the palates, which are close to the roof of the mouth, at the entrance to the throat. For this reason, most people consider that they only have two tonsils.

The function of these lymphoids is to protect the body, thus preventing other types of infections from happening. However, because it is one of the first organs to come into contact with pathogens, they are frequently infected.

According to the Brazilian Society of Pediatrics (SBP), in most cases, the disease affects children. In most cases, tonsillitis is caused by viruses, but it can be caused by bacteria and other unknown sources


Because it is a type of infection with many uncomfortable causes and symptoms (such as sore throat and difficulty breathing), tonsillitis can be divided into 4 distinct types:

  • Bacterial tonsillitis: when caused by bacteria;
  • Viral tonsillitis: when caused by viruses;
  • Acute tonsillitis: lasts for up to 3 months, being one of the most frequent airway infections;
  • Chronic tonsillitis: when the infection lasts more than 3 months or is recurrent.


Tonsillitis can be bacterial, viral, or neither. The factors that develop the disease without a specific cause are unknown. Understand:

Viral tonsillitis

Viruses are the most common cause of tonsillitis. It can be caused by the following viral agents:

  • Adenovirus: most common cause of most colds;
  • Rhinovirus: most common cause of viral infections in humans;
  • Influenza: virus that causes influenza;
  • Coronavirus: 6 strains of this virus are known, one of which causes Severe Acute Respiratory Syndrome;
  • EpsteinBarr Virus: causing infectious mononucleosis (or Kiss Disease);
  • Respiratory syncytial virus: frequent cause of various respiratory tract infections;
  • Cytomegalovirus: viruses belonging to the herpes-virus family, which cause cold sores or genital herpes.

Bacterial tonsillitis

The bacterium that most commonly causes tonsillitis is Streptococcus pyogenes, which belongs to group A of streptococci. However, the disease can also be caused by the following bacteria:

  • Staphylococcus aureus;
  • Mycoplasma pneumoniae;
  • Chlamydia pneumoniae;
  • Bordetella pertussis ;
  • Fusobacterium sp.;
  • Neisseria gonorrhoeae.

Risk factors

There are two risk factors that increase the chance that someone will develop tonsillitis. Are they:

Young age

The disease affects children more often. However, those less than 2 years old are rarely affected. Tonsillitis caused by bacteria usually occurs between the ages of 5 to 15 years, whereas viral tonsillitis is common in children younger than 5 years.

Frequent exposure to germs

Because they are in constant contact with classmates and, consequently, with various pathological agents, children in the school period can acquire tonsillitis more easily.

Tonsillitis symptoms

In addition to sore throat, which is a characteristic symptom of tonsillitis, the disease can still be characterized by several others, divided into more and less common:

Most common symptoms

  • Swollen and red tonsils;
  • Pain when swallowing;
  • Fever;
  • Cough;
  •  Headache;
  • Tiredness;
  • Chills;
  • Bad to be;
  • White spots with pus on the tonsils;
  • Swelling of the lymph nodes located in the neck;
  • Pain in the ears and / or neck;
  • Weight loss;
  • Difficulty in eating food and / or liquids;
  • Difficulty sleeping.

Less common symptoms

  • Nausea and vomiting;
  • Fatigue;
  • Stomachache;
  • “Hairy” tongue;
  • Bad breath;
  • Voice changes;
  • Difficulty opening your mouth;
  • Loss of appetite;
  • Anxiety and / or fear of suffocation.

Is tonsillitis contagious?

Yes, tonsillitis is a contagious disease, especially when it is of the viral type. Transmission is done by contact with the infected patient’s saliva. For the transmission of the pathological agent to be avoided, it is advisable to take the following precautions:

  • Always cover your mouth (with a handkerchief or forearm) when coughing;
  • Wash your hands thoroughly before handling anything or after using the bathroom;
  • Do not share items for personal use, such as glasses, cutlery, towels, etc.


First, it should be noted that, at the sign of any pain and / or inflammation, a visit to the doctor is necessary. In the case of tonsillitis, when symptoms such as sore throat start to bother the patient, the ideal is to go in search of a diagnosis with an otolaryngologist .

Once in the doctor’s office, the diagnosis can be divided into 3 phases:


The specialist will review the report of the symptoms you experience and / or describe based on:

  • Use of a luminous instrument to check the patient’s throat;
  • Check for the possibility of the patient having scarlet fever, a possible cause for sore throat;
  • Gently touch the patient’s neck to see if there are swollen lymph nodes;
  • Listening to breathing through a stethoscope;
  • Check for enlargement of the spleen (one of the symptoms of mononucleosis, a disease that can also cause swelling in the tonsils).

Tissue analysis

For correct treatment, it is necessary that the diagnosis is accurate. For this, an analysis of a sample of the tonsil tissue can be performed, which will identify whether the infection is being caused by bacteria or viruses.

Cell analysis exam

The doctor may also order a blood test to analyze the cells of the patient’s body. The test result can identify whether he has strep throat or not. If not, this test can then help determine the cause of tonsillitis.

Tonsillitis Treatment

Whether viral or bacterial tonsillitis, primary care for the disease is the same for all patients. However, when the cause is a bacterial infection, antibiotics can be prescribed so that the causative agent is more effectively eliminated from the body.

When you follow these precautions correctly, the symptoms usually disappear in 2 or 3 days.

Primary care

Among the basic care you should follow, you can highlight 6:

  • Rest: during rest, your body focuses all of its energy on fighting infection;
  • Fluids: by drinking plenty of fluids, your throat prevents it from becoming dry and becoming even more uncomfortable;
  • Solution with water and salt: gargling with a solution made of water and salt can help to improve discomfort;
  • Humidity: air humidifiers can remove the irritation that dry air causes;
  • Avoid irritating agents: moving away from toxic substances, such as cigarette smoke, can aid recovery.


Tonsilectomy surgery, also known as tonsillectomy, is always a great option for patients who meet any of these criteria below:

  • Sore throat caused by tonsillitis;
  • Episodes of sore throat that cause it to stop functioning normally;
  • 7 or more sore throats, treated correctly, in the last year;
  • 5 or more sore throats, each year, for the past two years;
  • 3 or more sore throats each year for the past three years.

The surgical procedure is performed under anesthesia and lasts between 30 to 45 minutes. It is done more frequently in children and the patient is discharged on the same day or, at most, the next day.

Recovery from surgery

After being discharged, the patient must stay at home for 7 to 10 days in order to fully recover from the surgery. It is normal for a sore throat of varying intensity to occur during this time. Some children also experience pain in the ears, jaw and neck.

To relieve these pains, the doctor responsible for the case may recommend painkillers or anti-inflammatory drugs.

During this recovery period, basic care to assist in the entire process is sufficient rest and the intake of plenty of fluids. Febrile conditions are recurrent at this stage, but if it is found that the fever is above 38ºC, the doctor should be consulted immediately.

Tonsillitis medications

Some medications may be prescribed by the doctor at this stage of primary care. They help fight the pain and fever caused by the disease and are listed below:

  •  BiProfenid ;
  •  Cataflam;
  •  Diclofenac Cholestyramine ;
  •  Diclofenac Resinate ;
  •  Dipyrone ;
  •  Flanax;
  •  Hexomedine;
  •  Ibuprofen ;
  •  Nimesulida;
  •  Paracetamol.

Antibiotics for bacterial tonsillitis

As already explained, in case of bacterial tonsillitis, antibiotic drugs will be prescribed and should be taken for at least 7 days, or for as long as it is prescribed.

Among these antibiotics are:

  •  Amoxicillin + Potassium Clavulanate ;
  •  Benzetacil ;
  •  Ceclor ;
  •  Cefaclor ;
  •  Cefadroxila;
  •  Ceftriaxone (Sodium and Disodium);
  •  Clavulin;
  •  Clindamicina;
  •  Erythromycin ;
  •  Hincomox.


NEVER self-medicate or stop using a medication without first consulting a doctor. Only he will be able to tell which medication, dosage and duration of treatment is the most suitable for his specific case. The information contained on this site is only intended to inform, not in any way intended to replace the guidance of a specialist or serve as a recommendation for any type of treatment. Always follow the instructions on the package insert and, if symptoms persist, seek medical or pharmaceutical advice.


Usually, in cases of tonsillitis, it is common for an abscess to develop laterally to the tonsils, characterized by accumulation of pus. This abscess is called a peritonsillar abscess .

In addition to this complication, for those suffering from chronic tonsillitis, it is common to suffer from problems such as snoring, mouth breathing, sleep problems and obstructive sleep apnea. All of them are caused by the exacerbated enlargement (hypertrophy) of the tonsils.

There are also some other complications developed due to the evolution of the disease. Are they:

  • Difficulty breathing, due to the obstruction of the airways;
  • Dehydration, due to the difficulty in drinking liquids;
  • Bacterial pharyngitis.

In extremely rare cases, more serious consequences can also happen if the patient does not take the prescribed antibiotics correctly. Among them are:

  • Rheumatic fever: inflammation that affects the heart, joints and other tissues in the body;
  • Glomerulonephritis: inflammation in the kidneys that makes it difficult to remove waste and excess fluids from the blood.


Because tonsils are a first defense against various infections, there is no concrete way to prevent tonsillitis. However, there are some steps that can be taken to make it less frequent. Are they:

  • Eat foods that have vitamins, such as fruits, vegetables, and fish;
  • Avoid situations that involve a lot of changes in body temperature, such as drinking very cold water, walking barefoot and getting wet in the rain;
  • Avoid cigarettes, as people who smoke are more likely to acquire the disease;
  • Avoid places with air conditioning, as it dries out the mucosa and decreases the resistance of the tonsils.

Tonsillitis is a very common disease, and most likely, your child’s recurrent sore throat may indicate a typical condition. Share the text with your friends and family and help us spread this information to as many people as possible!