Symptoms

The main symptom of tonsillitis is a sore throat. More symptoms occur in most cases. Some or all of the following may be present:

• Fever
• Bad breath
• Nasal congestion and runny nose
• Swollen lymph nodes
• Red, swollen tonsils covered completely or in patches by pus
• Difficulty swallowing
• Headache
• Abdominal (belly) pain
• Raw, bleeding patches on the tonsils

When you have sore throat plus cold symptoms such as nasal congestion, runny nose, sneezing, and coughing, the cause is most likely a virus. Viral infection of the tonsils usually goes away without treatment within 2 weeks.

Sore throat with a sudden fever above 101°F (38.3°C)—milder fever may point to a viral infection—and swollen lymph nodes, and without symptoms of an upper respiratory tract infection, may point to a bacterial infection. Anyone with these symptoms should see a doctor for diagnosis because of the risk of strep throat. Although strep throat will usually go away even without treatment, an untreated strep infection can lead to complications including rheumatic fever, which can permanently damage the heart.