Pharyngitis and Tonsillitis

What causes pharyngitis and tonsillitis?

There are many causes of throat infections. Viruses are the most common cause and antibiotics will not help. Causes of throat infections include: 

• Viruses (most common)
• Bacteria such as strep
• Fungal infections
• Parasitic infections
• Cigarette smoke
• Other causes

What are the symptoms of pharyngitis and tonsillitis?

The symptoms of pharyngitis and tonsillitis depend greatly on what’s causing it. For some people, symptoms may start quickly. For others, symptoms start slowly. These are the most common symptoms of pharyngitis and tonsillitis:

• Sore throat
• Fever (low-grade or high-grade)
• Headache
• Loss in appetite
• Not feeling well
• Nausea
• Vomiting
• Stomach aches
• Painful swallowing
• Redness or drainage in the throat

The symptoms of pharyngitis and tonsillitis may look like other health conditions or problems. Always check with your healthcare provider for a diagnosis.

How are pharyngitis and tonsillitis diagnosed?

In most cases, it is hard to tell the difference between a viral sore throat and a strep throat based on a physical exam. But it is important to know if the sore throat is caused by strep bacteria. Then antibiotics are needed to help prevent the complications that can happen with these bacteria.

As a result, most people with the above symptoms will get a strep test and throat culture to find out if it is an infection caused by strep. This will be done using a throat swab in the healthcare provider’s office.

Quick tests, called rapid strep tests, may be done. This may immediately show as positive for strep and antibiotics can be started. If it is negative, part of the throat swab will be kept for a throat culture. This will further identify strep in 2 to 3 days. Your healthcare provider will discuss the treatment plan with you based on the findings.

How are pharyngitis and tonsillitis treated?

Treatment will depend on your symptoms, age, and general health. It will also depend on how severe the condition is.

If bacteria are not the cause of the infection, the treatment is often more for comfort. Antibiotics will not help treat viral sore throats. Treatment may include:

• Acetaminophen or ibuprofen for pain and fever
• Drinking more fluids
• Throat lozenges
• Gargling with warm saltwater

Antibiotics are prescribed if the cause of the infection is bacterial.

What are possible complications of pharyngitis and tonsillitis?

Most cases of pharyngitis and tonsillitis will run their course without any complications. But if the disease is caused by strep, rare complications can happen. These include rheumatic fever, rheumatic heart disease, and kidney disease. Treatment with antibiotics can prevent these complications. In rare cases, a pocket of infection (peritonsillar abscess) can develop in the tissues around the tonsils. This may need surgery.

When should I call my healthcare provider?

If a sore throat is severe and includes trouble swallowing, drooling, or neck swelling, see a healthcare provider right away.

Key points about pharyngitis and tonsillitis

• Pharyngitis and tonsillitis are throat infections that cause inflammation.
• Pharyngitis and tonsillitis can be caused by viruses, bacteria, fungi, parasites, and cigarette smoking.
• Most infections are caused by viruses. Antibiotics don't cure a viral infection, and should not be used.
• If a bacterial infection is diagnosed, it will be treated with antibiotics.
• Pharyngitis and tonsillitis can be treated with pain relievers, drinking more fluids, throat lozenges, and gargling with warm saltwater.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

• Know the reason for your visit and what you want to happen.
• Before your visit, write down questions you want answered.
• Bring someone with you to help you ask questions and remember what your provider tells you.
• At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.
• Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.
• Ask if your condition can be treated in other ways.
• Know why a test or procedure is recommended and what the results could mean.
• Know what to expect if you do not take the medicine or have the test or procedure.
• If you have a follow-up appointment, write down the date, time, and purpose for that visit.
• Know how you can contact your provider if you have questions.

Medical Reviewer: Ashutosh Kacker MD

Medical Reviewer: Ronald Karlin MD

Medical Reviewer: Daphne Pierce-Smith RN MSN CCRC

© 2000-2022 The StayWell Company, LLC. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.