Tonsillitis Signs and Symptoms
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Do I Have Tonsillitis? All About Signs and Symptoms

Do I Have Tonsillitis? All About Signs and Symptoms
Everyday Health
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Updated on September 30, 2025
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Sore throats and colds are common during the winter months, especially for children. In many households, it can seem as though as soon one family member begins to recover, another starts to feel symptoms coming on. One unfortunate complication that can develop from such sickness is tonsillitis, or inflammation of the tonsils resulting from an infection.

Tonsillitis is often caused by the common cold. The virus starts with sniffles and a sore throat, but it can turn into a tonsil infection. Bacterial infections can cause tonsillitis, too, as well as other viral infections.

So how do you know if your cold or infection has affected your tonsils? Here are the signs and symptoms to look out for, in both adults and children.

How Do You Know When You Have Tonsillitis?

The symptoms you may experience when you have tonsillitis can include:

  • Red, swollen tonsils
  • A white or yellow coating or spots on the tonsils
  • Sore throat
  • Difficult or painful swallowing
  • Fever
  • Enlarged, tender glands (lymph nodes) in the neck
  • A scratchy, muffled, or throaty voice
  • Bad breath
  • An altered sense of taste
  • Stomachache, especially in younger children
  • Stiff neck
  • Headache
For very young children who may not be able to describe the symptoms they are experiencing, look for these characteristics:

  • Fever
  • Drooling, due to difficult or painful swallowing
  • Refusal to eat
  • Unusual fussiness

Do White Spots on the Tonsils Mean You Have Tonsillitis?

“If you look at someone’s tonsils closely, they will have these little crypts [and crevices] in them,” says James Clark, MBBCh, an assistant professor of otolaryngology-head and neck surgery at Johns Hopkins Medicine in Baltimore. “What can build up is old dead skin and bacteria.” When food, bacteria, or other debris get trapped in the crevices, they harden and calcify into tonsil stones.

You can get tonsil stones without having tonsillitis — in fact, many people get tonsil stones frequently. Tonsil stones are usually harmless, but in some rare cases, they can cause tonsillitis.

 That’s why you may notice those white spots and patches if you have tonsillitis.
“You can have tonsillitis without actually having the presence of the stones and vice versa,” Dr. Clark says. Sometimes the retained food and debris can lead to chronic halitosis (bad breath).

 The stones typically fall out by themselves, though some people scrape them out using a cotton swab, Clark notes.

When a person has a tonsil infection and there are stones, the stones are more likely to secrete pus, since that is part of the result of the tonsils swelling, according to Clark. You’ll get an accumulation of the dead immune cells that participated in fighting the infection, he says.

Tonsillitis Pain or Irritation in the Throat

Although everyone experiences pain differently, in almost all cases tonsillitis causes throat pain or irritation, such as a sore throat, difficult or painful swallowing, enlarged glands in the neck, and a scratchy voice (where you may feel more strain than usual to talk).

 Some people also experience headaches, stomachaches, or a stiff neck as a result of tonsillitis.

It’s worth noting the possibility that someone may carry the bacteria that causes strep throat (and therefore test positive by a strep test), but they may not actually be infected with the bacteria or experience pain or other symptoms, Clark says.

“They have strep within the tonsil tissue — but it’s not actively causing an infection; it’s just living there,” he explains. Antibiotics, the typical treatment for tonsillitis caused by bacterial infections, are not recommended in these cases, however, unless someone is experiencing symptoms of tonsillitis.

Is Tonsillitis Contagious?

Whether tonsillitis has been caused by a virus or bacteria, it can easily spread from person to person, because such infections are contagious.

 This is more likely when someone has an active infection, Clark says. “Good hygiene is the best strategy to try to avoid tonsillitis,” he adds.
Tonsillitis caused by a bacterial infection, such as Streptococcus pyogenes (group A streptococcus, the same bacteria that causes strep throat), is highly contagious. People with strep spread the bacteria by coughing and sneezing, which sends tiny droplets through the air that contain the bacteria. The infection can then be spread in any of the following ways:

  • Breathing in the droplets
  • Touching something that’s been contaminated with the droplets, then touching your mouth or nose
  • Drinking or sharing food with a person who has strep
  • Touching sores on the skin caused by group A strep (impetigo)

Bacterial and viral infections are passed from person to person in essentially the same ways.

When Should You Go See Your Doctor for Tonsillitis

In most cases, tonsillitis will go away on its own in about five to seven days, Clark says.

But sore throats are fairly common and can happen several times in a cold season, so it can be difficult to decide when it’s time to call your doctor.

Clark suggests calling your care provider if you are experiencing any of these symptoms:

  • Fever of at least 101 degrees F or 38.4 degrees C
  • Unable to eat or drink anything
  • The throat pain has not improved or has worsened three days after starting

He adds that you should seek urgent care such as an emergency room if these symptoms are present:

  • Drooling much more than usual
  • Difficulty breathing or swallowing
  • Stiff or swollen neck
  • Voice change

The Takeaway

  • Tonsillitis frequently follows a common cold, causing a sore throat, fever, and swollen tonsils due to viral or bacterial infections.
  • Look out for signs such as difficulty swallowing, tender lymph nodes in the neck, and white spots on the tonsils.
  • If your symptoms are severe or persist, it's important to consult your doctor for proper care.

Common Questions & Answers

What is tonsillitis?
Tonsillitis is the inflammation of the tonsils caused by infection, typically from the common cold or bacterial infections.
Symptoms of tonsillitis include red and swollen tonsils, white or yellow coating on the tonsils, sore throat, difficulty or pain while swallowing, fever, enlarged glands in the neck, bad breath, and stomachache.
Yes, tonsillitis can cause white spots or patches on the tonsils, which may be caused by trapped food, bacteria, or debris that hardens and forms tonsil stones. You can have tonsil stones without having tonsillitis.
Yes, tonsillitis usually causes pain or irritation, particularly in the throat. This can include a sore throat, painful swallowing, enlarged neck glands, and a scratchy voice.
Yes, tonsillitis is contagious. Whether caused by a virus or bacteria, it can easily spread from person to person through coughing, sneezing, touching contaminated objects, or sharing food or drinks.
EDITORIAL SOURCES
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
Resources
  1. Tonsillitis. Mayo Clinic. September 3, 2022.
  2. Tonsillitis. Johns Hopkins Medicine.
  3. Tonsil Stones. Cleveland Clinic. January 7, 2024.
  4. Tonsillitis. Mayo Clinic. September 3, 2022.
  5. Tonsillitis. Cleveland Clinic. October 12, 2023.
  6. About Strep Throat. Centers for Disease Control and Prevention. March 1, 2024.
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