Call your doctor if any of the following occur.

• Sore throat, along with any two of these signs of bacterial infection:
  • Fever of or higher
  • White or yellow coating on the tonsils
  • Swollen, tender tonsils
  • Swollen lymph nodes in the neck
  • Abdominal (belly) pain and headache
  • Severe pain
  • Severe difficulty swallowing
  • Pain on only one side of the throat
• Tonsillitis or sore throat that starts after being exposed to someone who has strep throat.
• Five episodes of tonsillitis in a year despite treatment.
• Persistent mouth-breathing, snoring, or a very nasal- or muffled-sounding voice.
• Signs of dehydration, such as a dry mouth and tongue and urinating less than normal.

Watchful Waiting

Watchful waiting is a period of time during which you and your doctor observe your or your child's symptoms or condition without using medical treatment. Watchful waiting is appropriate if tonsillitis occurs along with cold symptoms such as runny nose, nasal congestion, sneezing, and coughing. Tonsillitis with these symptoms is most often caused by a virus. Viral infection of the tonsils can be treated at home and usually goes away without treatment within 2 weeks. In general, the more like a cold the condition is, the less likely it is that the condition is caused by the strep bacteria.

Watchful waiting is not appropriate if tonsillitis occurs with fever of or higher or with swollen lymph nodes in the neck, and without symptoms of an upper respiratory tract infection. If these symptoms occur together, see a doctor. You may have strep throat, which should be treated promptly.

Who To See

The following health professionals can evaluate tonsillitis, perform quick tests or throat cultures, and prescribe antibiotic treatment if needed:

• Pediatrician
• Family medicine physician
• Otolaryngologist (ear, nose, and throat, or ENT, doctor)
• Nurse practitioner
• Physician assistant
• Internist

If surgery to remove the tonsils (tonsillectomy) is indicated, you may be referred to an otolaryngologist (ear, nose, and throat, or ENT, doctor).

To prepare for your appointment, see the topic Making the Most of Your Appointment.

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