Home ENT What are the common causes of tonsillitis?

What are the common causes of tonsillitis?

Verified By Dr EC Vinaya Kumar December 11, 2020 35287 0
What are the common causes of tonsillitis
What are the common causes of tonsillitis


Tonsillitis is a common and nagging problem that occurs primarily in young children and teenagers, characterized by the inflammation or swelling of the tonsil glands. The tonsil glands, which are small oval shaped glands located at the posterior part  of the throat . The tonsils are the immune system’s first line of defense against bacteria and viruses that enter your mouth. This function may make the tonsils particularly vulnerable to infection and inflammation. 

Can bacterial infections cause tonsillitis?

The main causes of tonsillitis are viral infections, but in certain cases, bacteria may also infect the tonsil glands. Streptococcus pyogenes is the main bacterium that is responsible for tonsillitis. Bacterial tonsillitis is more common in growing children and adolescents than in smaller children. Bacterial tonsillitis takes longer to cure than viral tonsillitis if left untreated. In the case of tonsillitis due to bacterial infection, antibiotics are the main and most effective treatment.

The symptoms of tonsillitis are as follows:

  • Swelling, reddening, and inflammation of the tonsil glands
  • Visible patches on the tonsil glands
  • Pain in the throat
  • Difficulty in swallowing, talking
  • Fever and chills
  • Swelling of the lymph nodes
  • Mouth odour
  • Scratched voice, etc.
  • Persistent headache, stiffness of head and neck, etc.

When to see a doctor?

You must seek medical help if your child or adolescent is showing the following symptoms:

  • Experiencing sore throat for more than 24-48 hours
  • Refusing food and water due to difficulty in swallowing
  • Remaining fussy, irritable and showing extreme fatigue
  • Fever

However, you must visit the doctor immediately if your child shows the following symptoms:

  • Facing breathing issues
  • Extreme pain in the throat and extreme discomfort in swallowing
  • Unable to swallow even  saliva and thus drooling continuously

Causes of tonsillitis

Tonsillitis causes, as discussed earlier, can be due to both viral as well as bacterial infection. The most common type of bacterial tonsillitis caused by the strain Streptococcus pyogenes. There are other strains of the streptococcus bacteria that also cause tonsillitis. Tonsillitis caused due to viruses heals on its own even without any medical treatment.

Risk factors of tonsillitis

The two major risk factors for bacterial tonsillitis are as follows:

  • Childhood and adolescence. Bacterial tonsillitis is more frequent in young children and teenagers. Bacterial tonsillitis is more common in children of  age group 5-15 .. Viral tonsillitis can be experienced more by younger children, children between the age group of 2-5. Tonsillitis in children below 2 years is comparatively rare.
  • Exposure to pathogens. School going children, we all know, are more exposed to infections  compared to adults due to their close proximity with their friends .

Treatment for tonsillitis

Antibiotics. Bacterial tonsillitis can be cured by following an antibiotic course. For tonsillitis caused due to Streptococcus, the most common course of treatment is taking the antibiotic penicillin orally for 10 days. If there is an allergy to penicillin, your doctor will give your child some other antibiotic.

Your child needs to complete a full course of antibiotic treatment even if the symptoms go away. An incomplete course of antibiotics will make the bacteria resistant to the medicine, and the symptoms may get worse, sometimes leading to rheumatic fever or even renal dysfunction in some cases. You must seek guidance from the doctor regarding the dose and duration of the antibiotic intake.

For tonsillitis caused by viruses, antibiotics do not help. Instead, the following measures  can be helpful:

  • Ensure that your child is well hydrated to keep his/her throat moist. A dry place is ideal for growth of organisms.
  • Ensure that your child gets enough rest so that the body gets to heal on its own
  • Warm beverages like a milk, hot chocolate, warm water with honey, soup can help.
  • Offer more Vitamin C to your child to boost the body’s natural immune system
  • Gargling with salt and lukewarm water is an excellent remedy for sore throat only if your child can gargle properly.
  • Steam inhalation is also a great remedy that keeps the throat moist and reduces irritation.

Surgery. In certain cases, tonsillectomy that is surgically removing the tonsil glands remains the only option. Your doctor will generally suggest a tonsillectomy procedure when tonsillitis occurs frequently, or frequent bouts of bacterial tonsillitis occur that cannot be treated with antibiotics. Tonsillectomy is also opted when chronic tonsillitis leads to breathing problems in children or disturbs their normal sleep, swallowing, or digestion patterns.

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Complications of tonsillitis

Chronic and frequent tonsillitis can lead to the following conditions:

  • Difficulty and obstruction while breathing
  • Sleep apnea which is theb disturbance and disruption in breathing patterns during deep sleep
  • Tonsillar cellulitis, a condition in which infection spreads to the nearby tissues
  • Peritonsillar abscess, a condition in which pus is collected behind the tonsil glands

Suppose your child is suffering from Strep throat or his/her tonsillitis are due to bacterial infection, and  has not finished the complete  antibiotic treatment. In that case, your child may experience the following complications:

Poststreptococcal glomerulonephritis. It is a life-threatening condition in which the kidneys fail to function properly; as a result, excess fluids and nitrogenous wastes accumulates in the blood.

Rheumatic fever. An inflammation in the body that affects different organs and tissues of the body like the heart, joints, etc.

Prevention of tonsillitis

Tonsillitis is a moderately contagious disease, so following basic hygiene is of utmost importance to check its spread. You must encourage your children to follow the steps given below:

  • Proper hand-washing  is very important, especially before and after meals
  • Ensure that your children do not share their spoons, food, water bottles, or other utensils with their friends
  • Discard their old toothbrushes after they have recovered from tonsillitis

Being a responsible parent, it is also important to restrict your child’s activities when he/she is suffering from frequent tonsillitis so that they do not spread the infection to others. You may adhere to the following:

  • Ensure that your ailing child stays at home till he/she has completely recovered
  • Ensure that your child covers his/her nose and mouth while coughing and sneezing


Tonsillitis can be due to either a virus or a bacterium. Tonsillitis, although a common problem in children and adolescents, can lead to complications if left untreated or ignored. It is important for parents to instil the habits of health and hygiene in their children right from early childhood to combat this disease.

Call 1860-500-1066 to book an appointment

Verified By Dr EC Vinaya Kumar
Consultant ENT Surgeon,
Apollo Hospitals, Jubilee Hills, Hyderabad

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