When Is Tonsillitis an Emergency? Symptoms to Look For (2024)

If you have tonsillitis, seek urgent medical care if symptoms last longer than 4 days, or if you’re having trouble breathing, eating, drinking, or opening your mouth.

Tonsillitis is an infection that causes the tonsils to become inflamed. Both viruses and bacteria can cause it, but viral tonsillitis is more common.

Anyone can get tonsillitis. Most people who develop the condition are young adults, teenagers, and children. Typically, tonsillitis causes symptoms such as:

• fever
• sore throat
• pain when swallowing
• earache
• red and swollen tonsils
• yellow and white spots on tonsils
• cough
• headache

These symptoms are generally mild. You can usually manage them at home with rest and over-the-counter (OTC) treatments.

When a tonsillitis infection becomes severe, symptoms will typically also be severe, making it important to seek urgent medical care.

Tonsillitis symptoms often resolve in a few days. You normally don’t need any specific treatments.

However, tonsillitis can become a severe infection. When this happens, it’s important to seek medical attention right away.

Symptoms that indicate that tonsillitis needs urgent medical attention include:

• if you think you or your child has strep throat
• it’s been more than 4 days and symptoms have not improved
• your symptoms are making it difficult to breathe
• your symptoms are making it difficult to eat and drink
• you have difficulty opening your mouth
• one of your tonsils appears larger than the other
• you’re experiencing drooling
• your voice sounds muffled

Young children might not be able to explain these symptoms as they experience them. Instead, you might notice that a child:

• is not eating
• is crying often
• is producing more saliva than usual
• appears to be having trouble breathing

If your child, or a child you’re caring for, is experiencing these symptoms, take them to a doctor as soon as possible.

Complications of tonsillitis happen when the infection spreads to other parts of the body. Complications typically only occur when bacteria cause tonsillitis.

Possible complications of severe tonsillitis include:

• An abscess: An abscess is a collection of pus. Severe tonsillitis can lead to an abscess, commonly called a peritonsillar abscess, that develops between one of your tonsils and the wall of your throat.
• Middle ear fluid and infection: A middle ear infection develops when the fluid between the eardrum and the inner ear becomes infected. Ear pain without fluid or infection can also be common due to referred pain.
• Obstructive sleep apnea (OSA): OSA is a condition that develops when the walls of the throat relax during sleep. It causes you to briefly stop breathing, interrupting your sleep and leading to symptoms such as snoring, daytime sleepiness, and headaches. Although you can have OSA symptoms when your tonsils are swollen from illness, tonsillitis does not cause OSA.
• Rheumatic fever: Rheumatic fever is an infection that causes inflammation throughout your entire body. It causes symptoms such as rashes, joint pain, and spasms. This type of infection is a complication of tonsillitis caused by strep throat.
• Scarlet fever: Scarlet fever is a severe infection. It can damage your organs and cause a pink-red skin rash. It’s a complication of tonsillitis caused by strep throat.
• Glomerulonephritis: Glomerulonephritis is an infection of the kidney’s filters. It leads to symptoms such as loss of appetite and vomiting. It’s a complication of tonsillitis caused by strep throat.

The progression of severe tonsillitis to other infections, such as rheumatic or scarlet fever, is rare and associated with strep throat. Progression is most likely to occur if strep throat is not treated.

Several infections can cause sore throats and fever that may seem like tonsillitis. For instance, it can be very difficult to tell on your own whether you have strep throat or tonsillitis. However, sometimes your symptoms can help point you in the right direction.

Strep throat is less likely to cause a cough or leave the tonsils red and swollen. If you’re coughing frequently and you can see redness and swelling when you look at your tonsils in a mirror, there’s a good chance you have tonsillitis and not strep.

Strep throat can occasionally cause a cough and tonsil swelling and redness. Looking for these symptoms isn’t a guaranteed method, but it can be a good way to evaluate your symptoms at home. You can read more about the symptoms of strep throat in this article.

Other conditions that can be mistaken for tonsillitis include:

• Sinus infection: A sinus infection causes symptoms that overlap with tonsillitis, such as a sore throat, coughing, fever, and headache. However, it also causes symptoms such as nasal congestion and nasal drainage. Sinus infections often resolve on their own. However, talk with a doctor if your symptoms worsen or don’t resolve after several days.
• Cold: A cold is a mild infection that causes symptoms such as a cough, sore throat, sneezing, and nasal congestion. Most people with colds don’t develop fevers. Treatment isn’t typically needed for colds.
• Flu: The flu causes symptoms such as a sore throat, fever, headaches, full body aches, coughing, nasal congestion, and appetite loss. You can typically treat it at home with rest. Antiviral medications can help relieve severe symptoms. If your flu symptoms are getting worse instead of better or haven’t resolved after 1 week, it’s best to get medical attention.

Tonsillitis is a common infection that causes inflammation in the tonsils. Typically, you can manage tonsillitis at home with rest and OTC medications.

However, it’s possible for tonsillitis to become a more severe infection. When this happens, symptoms such as a sore throat, fever, and coughing last for more than 4 days. They can make activities such as eating, drinking, and even breathing difficult.

Without treatment, severe tonsillitis can lead to the infection spreading. This can cause complications such as an abscess or a middle ear infection. Seeking treatment can help prevent these complications.