Tonsillitis is a common problem. Its main feature is a sore throat, which may be accompanied by fevers, chills and trouble eating. It may affect one side or both sides of the throat and can be a recurrent illness. Some people become dehydrated and even require hospitalisation for intravenous antibiotics and fluids.

Tonsil Function

The tonsils are part of the immune system. They are a ‘first defence’ against infection. Due to their location, they receive tiny parts of bacteria, viruses and other substances encountered in the mouth. They process this material and help to form or generate an immune response and create ‘memory’ in the immune system for fighting future problems.

They are at their most active when you are a child, as this is the time in life where you are building your immune system most aggressively. Hence, when you are small, they are often quite big as they are working hard.

Interestingly, the tonsils form only part of the immune system in that region. There are actually multiple sites of similar tissue in the mouth and oral cavity, which combine to perform the same function.

Causes of Tonsillitis

The tonsils can become overwhelmed and infected when exposed to some bacteria and viruses. Usually this is temporary and the tonsils recover fully while you develop an immune system ‘strategy’ to deal with that particular bacteria or virus should you become exposed again.

Unfortunately, in some cases, the infections become chronic. Symptoms usually improve with antibiotics, but return at regular intervals giving the person recurrent tonsillitis. Why the tonsils and immune system don’t clear this problem remains a bit of a mystery, however we do know that once you develop recurrent tonsillitis there comes a point where your health is likely to be better with removal of the tonsils rather than keeping them.

In some rare cases, infections of the tonsils can become overwhelming and lead to significant illness. People may develop an abscess of the tonsil called a “quinsy” or an abscess in other parts of the neck. In rare cases this can progress on to become a serious and even life-threatening illness.


The typical symptoms of tonsillitis include:

  • Sore throat with difficulty swallowing.
  • Fevers and chills.
  • Neck lumps / swollen lymph nodes.
  • Feeling generally unwell.

In rare cases, tonsillitis can become severe which may lead to:

  • Changes in voice.
  • Complete inability to swallow food and water.
  • Shortness of breath.
  • Neck pain and stiffness.

In these cases, medical advice should be obtained and hospital treatment may be required.


The diagnosis of tonsillitis is usually made by listening to the reported symptoms and looking in the throat. Often the tonsils will be enlarged, red and covered in pus.


Individual episodes of tonsillitis may be treated with a combination of pain relief, fluids and in some cases antibiotics. In most instances this will solve the problem and there will be no ongoing issues.

However, sometimes tonsillitis occurs over and over again. Once a person reaches a certain number of infections or experiences a serious complication, it will usually be recommended that the person have tonsil surgery. Dr Morrissey can discuss the pros and cons of this surgery with you should it be relevant to your situation.

Related Information

Tonsillectomy - Adult
Coblation Adenotonsillotomy