The Differences Between Tonsillitis and Strep Throat


Republished from Medical News Today

Tonsillitis and strep throat are similar illnesses that affect the inside of the throat and surrounding tissue.  They also share many of the same symptoms, including sore throat, headache, fatigue, and fever.  Because tonsillitis and strep throat are so similar, it can be difficult to tell them apart.

One key difference is that tonsillitis involves inflammation of the tonsils, while strep throat involves a specific bacterium infecting the throat. This could also affect the tonsils.  Because of this, a person could have strep throat with tonsillitis at the same time. However, a different bacterium could cause tonsillitis. Other germs, such as viruses, can cause this illness.

Most people who have a significant throat infection will need to see a doctor to find out whether they have tonsillitis or strep throat.  This article covers the similarities and differences between tonsillitis and strep throat, as well as what to do if either of these illnesses develop.


Tonsillitis means inflammation of the tonsils. The palatine tonsils are two small, oval shaped bumps located as one on both sides of the throat. They are the same pink color as the rest of the throat.

The tonsils are lymphatic system organs that are part of the immune system. The immune system helps the body fight off infections naturally. The tonsils stop germs from traveling further down the throat to the lungs. This is an important function in children, as their immune systems are still developing.

Strep throat, on the other hand, is short for streptococcal pharyngitis. This means inflammation of the throat due to the bacterium Streptococcus pyogenes. The medical term for the throat is the pharynx.


The majority of tonsillitis cases occur due to a virus. For example, rhinovirus commonly causes viral tonsillitis. This is the germ responsible for the common cold.

Other viruses that can cause tonsillitis include:

  • influenza A, which is a flu virus
  • herpes simplex virus
  • Epstein-Barr virus

Strep throat is always caused by a type of bacterium called group A Streptococcus (GAS), or S. pyogenes. People often shorten the name to “strep.” This type of bacterium also causes up to 30% of tonsillitis cases.

Both bacteria and viruses are organisms so small that people can only see them under a microscope. They can spread from person to person through respiratory droplets in a cough or a sneeze, as well as through the exchange of saliva.

Some ways to prevent exposure to these infectious organisms include:

  • washing the hands frequently and thoroughly
  • wiping down shopping carts before use
  • not sharing cups or eating utensils with someone who is ill
  • staying at home and resting if a fever occurs
  • avoiding contact with people who are sick

Comparison of symptoms

Although they have similar symptoms, tonsillitis may be milder than strep throat.  Below is a side-by-side comparison of some tonsillitis and strep throat symptoms.

Tonsillitis Strep throat
● sore throat
● swollen, red tonsils, sometimes with areas of pus
● swollen, tender lymph nodes in the neck
● painful swallowing
● fever
● headache
● runny nose
● postnasal drip
● bad breath
● cough
● sudden onset of sore throat
● swollen, red tonsils, commonly with areas of pus
● swollen, tender lymph nodes in the neck
● painful swallowing
● fever
● headache
● abdominal pain
● nausea and vomiting

When To See A Doctor

Because a lot of the symptoms of tonsillitis and strep throat are very similar, it is often necessary to see a doctor to determine the cause of the sore throat.

A person should also see a doctor if any of the following symptoms occur:

  • frequent or large amounts of drooling
  • an inability to take in fluids
  • difficulty breathing
  • a high fever of 101°F (38.3°C)
  • worsening fatigue or weakness


A doctor will first examine a person’s throat, feeling over areas of the head and neck. However, they cannot always tell if it is GAS, a different bacterium, or a virus causing the infection just by looking at the throat and tonsils.

A rapid strep test, or a throat culture, can verify whether or not it is strep throat. A doctor can also do a rapid viral nasopharyngeal swab test to check for certain viruses.

First, they will swab the back of the throat and tonsils to collect a sample. They will then place the sample in a container and mix it with a solution to check for the presence of the strep throat bacterium. The test will signal whether or not a GAS bacterium is present. The results will generally be available on the same day.

In some cases, a rapid strep test result can be negative, but the doctor may still suspect that a person has strep throat. In these cases, the doctor will send a throat culture out to a laboratory. It can take up to 2 days to get the results back.

Strep throat is most common among school-aged children, and doctors most often diagnose it in late winter and early spring. Acute tonsillitis commonly affects children aged 4–8 years and young adults aged 15–25 years. A doctor will be able to make a diagnosis of tonsillitis based on a person’s symptoms and a physical examination of their throat.

General management tips

Even though different germs cause tonsillitis and strep throat, some home treatment measures can help ease the symptoms of both. These include:

  • taking acetaminophen or ibuprofen for pain and fever relief
  • drinking plenty of fluids
  • sipping warm drinks, such as tea made with honey and lemon
  • sucking on ice chips, popsicles, or soothing throat lozenges
  • using a room humidifier at night if the air in the bedroom is dry
  • avoiding exposure to smoke and irritants, as these will irritate the throat
  • avoiding citrus fruits such as orange and pineapple, as these may irritate the throat
  • gargling with salt water every few hours, using half a teaspoon of salt mixed in 8 ounces of water

People who wish to try a saltwater gargle should take a comfortable mouthful and gargle for several seconds before spitting it out.  Most people with strep throat or tonsillitis will eventually feel better without additional treatment.


Tonsillitis and strep throat are common illnesses that most often affect those aged 4–25 years. Most cases will cause minor discomfort and resolve without complications within 1 week, but someone with strep throat will likely need antibiotic therapy. If a person does not feel better after 1 week or notices that their symptoms suddenly worsen, they should contact a doctor.

At Pacific Eye & Ear Specialists, we employ thorough evaluation and treatment regimes. Call our office today for an appointment with our top Los Angeles ENT physicians and Audiologists.

If you have any questions, feel free to call us at (310) 477-5558.

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