Symptoms of tonsilitis

Acute tonsillitis

The typical symptoms of acute tonsillitis are a very sore throat with bright red, swollen tonsils. The onset of pain may be rapid or gradual. These symptoms may be accompanied by any of the following:

• A white or yellow coating or spots on the tonsils
• Drooling and difficulty swallowing saliva
• Ear pain when swallowing
• Bad breath
• Swollen and tender lymph nodes in the neck under the jaw
• Fever
• Headache
• Repeated infection may cause the formation of small depressions, called crypts, on the surface of the tonsils.
• hese crypts can harbour bacteria and may contain pus.
• Sometimes small hard secretions called "tonsilloliths" develop in these crypts. These hard secretions may contain sulphur and give off a characteristic "rotten egg" smell when crushed. This contributes to the patient’s bad breath.
• Tonsilloliths may also cause the unpleasant sensation of having something caught in the back of the throat.

Tonsillar abscess (Quinsy's abscess)

In addition to inflamed tonsils, a tonsillar abscess can result in:

• Severe pain and tenderness around the area of the soft palate, at the roof of the mouth
• Difficulty swallowing
• Muffled speech caused by swelling from the abscess
• Difficulty opening the mouth

Hypertrophic tonsils (enlarged tonsils)

Enlarged tonsils and adenoids can obstruct breathing. This can result in:

- Snoring 

- Disturbed sleep patterns, including:

• Sleep apnoea (when the child stops breathing for brief periods while asleep)
• Frequent awakening from sleep
• Restless sleep
• Nightmares
• Bed wetting 

Such sleep-related problems can lead to the development of mood changes, excessive sleepiness, poor appetite and sometimes even heart problems.

• Chronic mouth breathing. This may sometimes result in the teeth to becoming poorly aligned (malocclusion).
• Chronic enlargement and infection of the tonsils, in combination with adenoidal infection, can cause infections in other nearby structures:
• The air passages in the region of the nose may become infected (sinusitis) and problems with nasal drainage or obstruction can develop.
• The Eustachian tubes of the ears may also be affected, resulting in chronic ear infections. 

Read more: 

What is tonsillitis? 

Diagnosing tonsillitis  

Causes of tonsillitis 

Reviewed by Prof Eugene Weinberg, Paediatrician Health24, February 2015.