Tonsillitis refers to the inflammation of the tonsils. It is usually caused by viruses or by bacterial infection. When viral infection is the cause, tonsillitis usually resolves without any treatment but rest, fluids, and pain medication as needed.

Tonsillitis caused by bacterial infection is very frequently the result of strep bacteria. Tonsillitis caused by strep, or strep throat, is usually accompanied by fever. The tonsils appear swollen and may be coated in a white infectious substance or have white spots. Sometimes strep throat can cause extreme headaches and glands under the jaw may be swollen or sore.

Strep throat must be treated with antibiotics. Lingering strep throat can progress to the very serious scarlet fever or to rheumatic fever, which can damage the heart. Strep is now often diagnosed within minutes at a doctor’s office through a rapid strep test. Those who experience the above symptoms, especially extreme sore throat accompanied by fever, should not hesitate to see a doctor, as symptoms can be rapidly resolved with antibiotics.

Certain viruses can cause tonsillitis, and most are relatively minor and will resolve without treatment. However, tonsillitis accompanied by ache in the stomach, slight fever, and a feeling of extreme exhaustion may indicate mononucleosis (mono). Though the primary treatment for mononucleosis is rest, some serious complications can arise from the illness. Those suspecting mono should see a doctor to rule out complications like an enlarged liver or spleen.

Occasionally tonsillitis is chronic and does not resolve on its own. Swallowing may become difficult with swollen tonsils. Breathing during sleep is also affected, causing snoring, premature waking and occasionally sleep apnea, the cessation of breathing for a short period of time.

Chronic tonsillitis can sometimes be the result of allergies. In other cases, the tonsils simply do not recover well from viral infections or bacterial infections and sore throats can occur frequently. Frequent sore throats, defined as more than five a year, should be investigated for chronic tonsillitis. When breathing, swallowing or sleeping is impaired by tonsillitis, physicians may suggest removing the tonsils.

Some recent studies have indicated that tonsillectomies, once much more common than now, may result in behavioral changes in children. One clinical study performed tonsillectomies on children diagnosed with attention deficit and hyperactivity disorder (ADHD), and chronic sore throats. This study found that tonsillectomies frequently resolved symptoms of ADHD. The possible cause for this appearance of symptoms suggests that lack of sleep due to tonsillitis may impact behavior and mimic ADHD symptoms.

Another recent study suggests that chronic tonsillitis may be the result of exposure to forms of the human papillomavirus virus (HPV). Approximately 30% of tonsillitis cases in a study conducted in Lithuania in 2004 were found to have HPV as well.