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Swollen Tonsils

What are the Tonsils?

First of all, let me explain about the tonsils to understand about the swollen tonsils or tonsillitis. The tonsils are present at the end of the throat (pharynx), one on either side of throat. The tonsils (palatine tonsils) are made by soft tissue masses. These tissues are similar to lymph nodes (the “glands” you can feel at the front of your neck) and tansies are part of the immune system. They act as filters and trap the germs. Otherwise, they will pass through the throat into our body. Tonsils also manufacture antibodies to fight against the germs and infection. These act as the first line of defense in throat and fight against the infections. They are different in size from person to person and get swelled in response to infection.

When you get a sore throat, at that time, your tonsils are doing their job of fighting against the infection. However, removal of the tonsils does not seem to increase susceptibility to infection.

What are Swollen tonsils or Tonsillitis?

When the tonsils get infected during the defense, such a condition is called swollen tonsils or tonsillitis. It is a common infection in kids; however, swollen tonsils can occur in any age. In fact, they become inflamed due to the presence of bacteria or virus. When you examine the swollen tonsils or tonsillitis, they seem to be coated with yellowish-white pus.

Picture of swollen tonsils

It is possible to suffer from multiple episodes of swollen tonsils through the life. It is quite interesting that some people have enlarged tonsils naturally but it doesn’t mean that they’d have been associated with infection symptoms and disease. Swollen tonsils or tonsillitis are associated with other symptoms such as fever, chills, sore throat, sneezing, hoarseness, headache, enlarged lymph nodes, fatigue or muscle aches.

Swollen Tonsil on One Side

Sometimes, swelling of tonsils occurs only on one side. It means you have only one swollen tonsil. It is most common in the children between ages 2-15. It might be a condition of tonsillitis or it might be due to a couple of other reasons. However, it is usually due to tonsillitis, with same symptoms, causes and it needs same medical care.

Causes of Swollen tonsils

During executing their job, tonsils get infected by the virus and bacteria. They can get these infections through various sources including pollution, STD, air etc. Common causes of swollen tonsils are:

Bacteria that cause tonsillitis

  • Streptococcus (strep) bacteria causing strep throat
  • Neisseria gonorrhoeae
  • Mycoplasma pneumonia
  • Bordetella pertussis
  • Chlamydia pneumonia
  • Fusobacterium sp

Virus that cause tonsillitis

  • Parainfluenza viruses
  • Enteroviruses
  • Cytomegalovirus
  • Measles virus
  • Herpes simplex virus
  • Influenza virus
  • Adenovirus
  • Epstein-Barr virus (mononucleosis)

Swollen tonsils in toddlers

To identify swollen tonsils in toddlers, you’ll have to observe certain things like their decreased appetite and drooling; at times, the baby drools more than usual because the swollen tonsils hurts her. Other symptoms include bad breath, fever, and change in voice, headache, ear pain and overall malaise.

Doctors can easily feel the tonsillitis in toddlers by examining their neck. Swollen tonsils are very common in toddlers and almost all the kids have multiple episodes of swollen tonsils throughout childhood.

Symptoms of Swollen tonsils

Undoubtedly, the biggest and visible symptom of the swollen tonsils is sore throat and it needs medical care. Other symptoms are:

Severe symptoms

  • Tenderness or throat pain
  • Swollen tonsils with white spots
  • Odynophagia (painful swallowing)
  • Redness on the tonsils
  • High fever
  • Dysphagia (difficulty swallowing)
  • Enlargement of lymph node
  • Severe pain in neck or ear
  • Difficulty in sleeping
  • Headache
  • Chills
  • Coughing
  • Petechiae, or small red or purple spots on the roof of your mouth

Less common symptoms

  • Fatigue
  • Nausea
  • Pain in stomach
  • Vomiting
  • Difficulty in opening the mouth
  • Voice changes
  • Smelly breath
  • Furry tongue

Critical condition

It is a condition in which you must take the medication as soon as possible. These conditions include:

  • Stiff neck
  • Fever over 103 ˚F
  • Severe weakness in muscles
  • Sore throat for more than two days

If you have any of the above mentioned symptoms, you must ask your doctor what to take for swollen tonsils.

Swollen Tonsils but No Fever

Sometimes, people observe swollen tonsils without having fever and you’ll feel no pain. It may be because some people have enlarged tonsils than others. Another aspect is that you might have an infection that is at the early or first stage where the symptoms might not have appeared completely. But you must be vigilant and contact to your doctor immediately.

How to diagnose swollen tonsils or tonsillitis?

Generally, it is done through a physical examination. Let me tell you about different methods carried out by the doctor.

Throat (pharynx) swab

This process is carried out in your doctor’s office. The doctor takes a throat culture by swabbing the throat. After that, test is carried out in the laboratory to identify the presence of bacteria. Usually this is done to check for bacteria such as Streptococcus.

Monospot test

It is a blood test done to identify the presence of a type of antibody (heterophile antibody). It is used to verify the symptoms of infection due to mononucleosis.

Epstein-Barr virus antibodies

If the result of Monospot test is negative, presence of antibodies in the patient’s blood that fight against EBV, help to identify the mononucleosis.


Treatment of swollen tonsils heavily depends upon the cause. For instance, it will have to first be diagnosed whether you’re suffering from bacterial or viral disease.

In most cases, when the infection is due to the virus, doctors don’t recommend antibiotics because the antibiotics don’t affect the virus. In such a situation, the infection will fade away in a few days and the patients will be recovered.

But if you’re suffering from bacterial infection, doctor will recommend antibiotics. In this respect, you must take all the medicines prescribed by the doctor. Generally, doctor prescribes antibiotics for 7 to 10 days, however, you’ll see improvement within 3 to 4 days. You must take the medicines for full 10 days so that the infection may not emerge again. The doctor may also advice a follow up check up.

The penicillin antibiotic category is prescribed in bacterial infection. It can be taken through injection (a shot) or mouth (pills taken orally). In a case when the patient is allergic to penicillin, he can take alternative antibiotics.

Home remedies

Home remedies are very popular to deal with the issue of swollen tonsils or tonsillitis. In addition to the antibiotics, patient can use these remedies. These help in pain relief and quick recovery. The following are some home remedies you can try as a means of treating swollen tonsils:


Gargling of Luke salty water can help to reduce pain.

Avoid dehydration and stay hydrated

Drink plenty of water. Apparently, it will be difficult to drink plenty of water due to sore throat but if you’ll not do this, there are great chances of dehydration. If you have high fever, you must drink fluid or liquids to avoid dehydration. Otherwise, it can lead to fatigue and severe headache.

Avoid dry air and use steam

Sitting in a steamy bathroom or using air humidifier can alleviate the problem.

Avoid smoke

Avoid tobacco smoking and smoky places


Take lots of rest. It helps the body to regain energy and fight against infection.

How long does Swollen tonsils last?

9 out of 10 patients recover from swollen tonsils or tonsillitis within 7 days. The symptoms last up to 3 days. The patients start recovering within 4 days after the infection. The interesting thing is that if you don’t take any medicine, even then, you’ll get recovered, according to the medical standards. The reason is that our immune system fights against infections naturally. However, medication increases the speed and chances of recovery.


Swollen tonsils disappear within 3 to 4 days and the fever associated also disappears within 7 to 10 days, however, in chronic swollen tonsils, the condition of the patient becomes worse. Remember, complications only occur if the reason of swollen tonsils or tonsillitis is bacterial infection.

Possible complications

Middle ear infection (otitis media)

In this condition, the fluid between the eardrum and the inner ear gets infected due to bacteria.

Obstructive sleep apnoea (OSA)

In this situation, the walls of the throat relax during the sleep and it causes difficulty in breathing thus leading to disruptive sleep at night.

Abscess (collection of pus) or quinsy (peritonsillar abscess)

It is the accumulation of pus between the throat wall and tonsils.

Rare complications

Rheumatic fever

It is a severe condition in which the infection spreads throughout the body of the patient. It causes jerky body movements, joint pain and rashes.


In this situation, the kidney filters get swelled and it causes vomiting and loss of appetite.

Scarlet fever

In this condition, a distinctive pink-red skin rash can be observed on patient’s body.

Pictures of Swollen tonsils

Pictures of swollen, red and enlarged tonsils…

Picture of enlarged swollen tonsils

Swollen tonsils on both sides

Photo of red Swollen tonsils


Tonsils are removed through surgery when they become enlarged and stop the passage of the upper airway. This condition results in breathing difficulty. The process is called tonsillectomy. They may also be removed if strep throat or recurrence of tonsil infections cannot be treated properly through antibiotics. This surgery is common in kids than adults. However, it can be performed at any time of age.

When you need tonsillectomy?

  • Severe breathing issue due to swollen tonsils
  • If you’ve had at least seven cases of tonsillitis
  • Sleep apnea or stop breathing intervals during the sleep
  • Tonsils bleeding
  • Trouble in swallowing food, particularly meat
  • Tonsil cancer
  • Loud and frequent snoring

Procedure of tonsillectomy

Two weeks before the surgery, stop taking antibiotics you’re taking for the inflamed tonsils. The reason is that these drugs can increase the risk of bleeding during and after tonsillectomy, for instance medicines such as naproxen, ibuprofen, and aspirin. You must stop eating and drinking at least 12 hours before going for the surgery. The entire process of tonsillectomy takes about half an hour.

There are several different ways to remove the tonsils’, however, the most common procedure is known as cold knife (steel) dissection. In this procedure, the doctor uses a scalpel to remove the tonsils of patient.

Another procedure is known as cauterization. In this process, the tissues are burned away. In this method, Ultrasonic vibration (using sound waves) is used.

Whatever the method your doctor will prefer, he will use general anesthesia. So you’ll not feel any pain during the surgery. You can leave the hospital same day.

Recovery process

The recovery time is 7 to 10 days. The following guidelines are recommended:


There are no specific restrictions, however soft diet is preferred. In fact, chewing and swallowing help the speedy recovery. However, you can feel pain while swallowing food.


Drink plenty of water because it is really important for the recovery. Start drinking fluid or liquid immediately after the surgery. If you feel nausea or vomiting, it is due to the anesthesia. It will fade away in 24 hours. If you feel severe nausea or dehydration, immediately contact to your doctor.


You can feel mild fever after one to two days of the surgery. If the temperature is greater than 102 ºF , contact your doctor immediately.

Physical activity

After two weeks of surgery, you can return to normal activities like travelling, joining office or school. There is no need of medication after two weeks.

Breathing issues

Mouth breathing and snoring can be observed due to the swelling of throat. These things should return to normal within 7 to 10 days after the surgery.

Bleeding issue

You can expect small specks of blood in saliva or from your nose. However, there should be no bright red blood. If such thing happens, immediately contact to your doctor.


Thick and white scab would be formed on the place of removed tonsils. It is quite normal. These will fall away into tiny pieces within 4 to 6 days after the surgery.


You may observe mild to severe pain in the throat after surgery. You can feel pain in your neck, jaw or ear. Your doctor will recommend pain relief medication.

How to relieve the pain

You have to use it for a few days after the surgery. Immediately contact your doctor if side effects are suspected or if pain is not well-controlled.

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