Tonsillitis: Symptoms, Causes, Treatment and When to See a GP

Tonsillitis is inflammation of the tonsils, usually caused by an infection. It causes a sore throat, pain when swallowing and often a fever. Most cases are caused by viruses and get better within about a week with rest, fluids and pain relief. Some bacterial infections need antibiotics, and a few warning signs mean you should get help quickly.

Here’s how to recognise tonsillitis, what you can do at home, when to see a doctor and how telehealth can help.

What is tonsillitis?

Your tonsils are two small pads of tissue at the back of your throat, one on each side. They’re part of the immune system and help trap germs that enter through the mouth and nose. When they become infected, they swell and become red and painful. This is tonsillitis.

Tonsillitis is most common in children and teenagers, but adults get it too. It spreads through droplets from coughs and sneezes, and by sharing cups, cutlery or towels.

Symptoms of tonsillitis

• a sore throat, often severe
• pain or difficulty swallowing
• red, swollen tonsils, sometimes with white or yellow patches
• fever
• tender, swollen glands in the neck
• bad breath
• a husky or muffled voice
• headache, tiredness and feeling generally unwell

Young children may not be able to describe a sore throat. Instead, they might refuse food or drink, drool more than usual, be irritable, or complain of a tummy ache.

What causes tonsillitis?

Viral tonsillitis

Most tonsillitis is caused by viruses, including the ones that cause colds and flu. Viral tonsillitis often comes with other cold symptoms, such as a runny nose, cough or hoarse voice. Antibiotics don’t work against viruses. If you’d like to know more about these viruses, read our guide to common respiratory viruses.

Glandular fever (caused by the Epstein-Barr virus) can also cause tonsillitis, often with marked tiredness and swollen glands that last longer than usual.

Bacterial tonsillitis

Some tonsillitis is caused by bacteria, most commonly group A streptococcus (“strep throat”). Bacterial tonsillitis is more likely when there’s a fever, swollen tender neck glands and pus on the tonsils, without a cough or runny nose. But symptoms overlap, so a doctor’s assessment helps work out the likely cause.

What helps at home

Whatever the cause, these steps can make you more comfortable while your body fights the infection:

• Rest and take time off work, school or childcare while you have a fever.
• Drink plenty of fluids. Cool drinks, warm drinks with honey (not for babies under 12 months) and ice blocks can all soothe the throat.
• Eat soft foods, such as soup, yoghurt, jelly or ice cream, if swallowing is painful.
• Gargle with warm salt water (about half a teaspoon of salt in a glass of warm water), if you’re old enough to gargle without swallowing.
• Use simple pain relief. Your pharmacist can recommend pain and fever medicine suitable for your age, or your child’s age and weight. Don’t give aspirin to children unless a doctor advises it.
• Throat lozenges or sprays may help older children and adults. Lozenges aren’t suitable for young children because of the choking risk.

Most people start to feel better within a few days and recover in about a week.

Do you need antibiotics for tonsillitis?

Often not. As healthdirect notes, most people with tonsillitis don’t need antibiotics. Taking them for a viral infection won’t help you recover faster and can cause side effects and contribute to antibiotic resistance.

A doctor may recommend antibiotics if bacterial tonsillitis is likely, symptoms are severe, or you’re at higher risk of complications. In some communities, including some Aboriginal and Torres Strait Islander communities, strep throat is treated more readily because of the risk of rheumatic fever. If antibiotics are prescribed, take the full course as directed.

A throat swab may be suggested to help confirm the cause. This needs to be done in person, at a clinic or pathology collection centre. Read more in our article on antibiotics and resistance.

Recurrent tonsillitis and tonsillectomy

Some people get tonsillitis again and again. If it keeps happening, is affecting school or work, or causes problems such as snoring and pauses in breathing during sleep, a GP can discuss whether a referral to an ear, nose and throat (ENT) specialist is appropriate. Removing the tonsils (tonsillectomy) is now usually reserved for frequent, severe infections or complications, and the benefits and risks are weighed up for each person.

When to see a GP

See a doctor if:

• your sore throat is severe, or isn’t improving after 3 to 4 days
• pain is getting worse despite pain relief
• pain is much worse on one side of the throat
• you have a high fever, or a rash appears
• you’re struggling to drink enough and may be getting dehydrated
• you have extreme tiredness or symptoms that drag on, which could suggest glandular fever
• you keep getting tonsillitis
• you have a weakened immune system, or a history of rheumatic fever

When to get urgent help

Call 000 or go to your nearest emergency department if you or your child:

• has difficulty breathing or noisy breathing
• is drooling or can’t swallow saliva or fluids
• can’t open the mouth fully, or has a muffled “hot potato” voice with severe one-sided throat pain (possible signs of a throat abscess, called quinsy)
• has a stiff neck, or is very drowsy or confused
• has a rash that doesn’t fade when pressed

How Teldoc can help

A sore throat is one of the most common reasons people book a telehealth appointment. Our AHPRA-registered GPs are available by phone or video, 7 days a week from 9 am to 7 pm (Sydney time), and most patients are seen within 15 minutes. On a video call, your doctor may ask to see your throat and neck. They can:

• assess your symptoms and check for warning signs
• give advice on managing pain and fever at home
• prescribe treatment if clinically appropriate, with an eScript sent to your phone
• arrange a throat swab or blood test through our pathology referrals if needed
• provide a medical certificate for work or study, or a carer’s certificate if your child is unwell
• provide a specialist referral to an ENT surgeon if appropriate
• tell you if you need to be examined in person

Consultations are $55 on weekdays and $75 on weekends and public holidays. Babies under 12 months are bulk billed with a valid Medicare card. See our fees page, or read more about our online tonsillitis consultations.

Frequently asked questions

How long does tonsillitis last?

Most people recover in about a week. Symptoms are usually worst in the first few days. See a doctor if your sore throat is severe or isn’t improving after 3 to 4 days.

Is tonsillitis contagious?

Yes. The viruses and bacteria that cause tonsillitis spread through coughs, sneezes and shared cups or cutlery. Stay home while you have a fever, wash your hands often and cover coughs and sneezes.

Can tonsillitis go away without antibiotics?

Yes. Most tonsillitis is caused by viruses and gets better on its own with rest, fluids and pain relief. A doctor may recommend antibiotics if a bacterial infection is likely or you’re at higher risk of complications.

Can a doctor diagnose tonsillitis over telehealth?

Often, yes. A GP can usually assess tonsillitis by talking through your symptoms and looking at your throat on video. If a swab or an in-person examination is needed, they’ll let you know.

When is tonsillitis an emergency?

Call 000 if there’s difficulty breathing, drooling or inability to swallow saliva, trouble opening the mouth, or severe one-sided throat pain with a muffled voice. These can be signs of a serious complication.

This article is general health information and isn’t a substitute for advice from your own doctor. If you’re worried about your health, speak to a GP. In an emergency, call 000.

Medically reviewed by Dr Vafa Derakshan (MBBS, FRACGP), September 2026