Tonsillitis vs Strep Throat: Symptoms, Causes, Treatments

May 02, 2024 | 5 min read

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Tonsillitis and strep throat are common conditions that often cause significant discomfort due to throat pain. Tonsillitis, which can be caused by viruses or bacteria, involves inflammation of the tonsils, whereas strep throat is a specific bacterial infection that affects the throat and tonsils.

tonsillitis vs strep throat

What is Tonsillitis?

Tonsillitis is a prevalent condition that accounts for about 1.3% of outpatient visits, as per NCBI publication. Tonsillitis is an inflammation of the tonsils, which are two oval-shaped pads located at the back of the throat. This condition is common, affecting individuals of all ages, but it is particularly prevalent among children and young adults. The inflammation can be caused by both viral and bacterial infections, leading to symptoms that may vary in severity.

The tonsils are part of the immune system, playing a key role in protecting the body against infection. When they become inflamed, it's often because they are fighting off invaders such as viruses or bacteria. Common symptoms of tonsillitis include a sore throat, difficulty swallowing, and visible redness or swelling of the tonsils. In some cases, the tonsils may have white or yellow patches, indicating an accumulation of pus.

What is Strep Throat?

Strep throat, on the other hand, is a specific type of sore throat caused by infection with a bacterium known as Streptococcus pyogenes, or group A streptococcus. 

This condition is highly contagious and is characterized by a severe and sudden sore throat without the cough that typically accompanies viral infections. It is particularly common among children aged 5 to 14 years, with approximately 288.6 million cases reported globally each year, according to the NCBI article.

Unlike tonsillitis, which can be caused by various types of germs, strep throat is always caused by this particular bacterium. Symptoms of strep throat can include pain when swallowing, fever, swollen lymph nodes in the neck, and red tonsils with white patches or streaks of pus. Notably, strep throat can occur with or without tonsillitis.

Symptoms Comparison

Understanding the symptoms of tonsillitis and strep throat is key to distinguishing between these two common throat conditions. Both can cause significant discomfort but have distinct indicators and potential complications.

Symptom Tonsillitis Strep Throat
Onset of Sore Throat Gradual Sudden and severe
Cough Common Rare
Swollen Tonsils Often red and swollen; white or yellow spots Red and swollen; white patches or streaks
Swollen Lymph Nodes Usually swollen and tender Usually swollen and tender
Fever Common; usually mild Common; often high
Painful Swallowing Yes Yes
Body Aches Less common Common
Headache Less common Common
Nausea or Vomiting Rare More common in children


Additional Distinguishing Symptoms:


  • Redness and swelling of the tonsils, sometimes accompanied by white or yellow patches.
  • Possibly accompanied by a cough or runny nose, indicating a viral cause.
  • Stiff neck and headaches can also occur.

Strep Throat:

  • Presence of tiny red spots on the roof of the mouth.
  • Nausea, vomiting, and abdominal pain, more common in children.
  • No cough associated, which can help differentiate it from a viral illness.

Detailed Description of Overlapping Symptoms

Both conditions feature sore throat and painful swallowing as primary symptoms, making initial self-diagnosis challenging. However, the presence of a cough usually suggests tonsillitis, especially if it's linked with a common cold or other respiratory infection. On the other hand, the sudden onset of a severe sore throat without coughing, accompanied by high fever and body aches, strongly indicates strep throat.

Furthermore, the appearance of the tonsils can be a telltale sign. While both conditions can cause red and swollen tonsils, the presence of distinct white patches or streaks is more typical of strep throat, whereas tonsillitis might show a more uniform white or yellow coating if pus is present.

Both conditions are a source of discomfort and can have overlapping symptoms, making it tricky to distinguish between them without a professional diagnosis.

If you're experiencing persistent throat discomfort, Symptom Checker can be your first step towards identifying your condition. However, it's important to consult a healthcare provider for a definitive diagnosis and appropriate treatment plan.

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Causes of Tonsillitis and Strep Throat

Causes of Tonsillitis

Tonsillitis can be caused by various types of bacteria and viruses. The most common viral causes include the Epstein-Barr virus (responsible for mononucleosis), adenovirus, and the respiratory syncytial virus. Bacterial tonsillitis might be caused by Streptococcus pyogenes, but it is less common than viral tonsillitis.

Causes of Strep Throat

Strep throat, conversely, is exclusively caused by the group A Streptococcus bacteria. This bacterium spreads through respiratory droplets when an infected person coughs or sneezes, making it highly contagious among those in close contact.

Treatment Options for Tonsillitis and Strep Throat

Treating Tonsillitis

Tonsillitis treatment depends largely on whether the infection is viral or bacterial:

Viral Tonsillitis:

Since it's caused by viruses, the primary treatment is supportive care, which includes:

  • Resting to help the body heal.
  • Drinking plenty of fluids to stay hydrated.
  • Gargling with salt water to ease throat pain.
  • Using humidifiers to add moisture to the air, which can soothe a sore throat.
  • Over-the-counter pain relievers to reduce fever and alleviate pain.

Bacterial Tonsillitis:

If tonsillitis is bacterial, typically confirmed via a throat culture, antibiotics will be prescribed. It’s crucial to:

  • Take the full course of antibiotics as prescribed, even if symptoms improve, to completely clear the infection.
  • Follow up with your doctor if symptoms do not improve within 48 hours of starting antibiotics.

Treating Strep Throat

Strep throat requires medical treatment with antibiotics to prevent complications and speed recovery.

Treatment includes:

  • Antibiotics: Medications such as penicillin or amoxicillin are commonly used to treat strep throat. Completing the full course of antibiotics is essential.
  • Symptomatic Relief: In addition to antibiotics, treatment for strep throat may include:
  1. Over-the-counter pain relievers, such as acetaminophen or ibuprofen, to help reduce throat pain and fever.
  2. Plenty of rest to help the body fight the infection.
  3. Staying hydrated with warm teas or water to soothe the throat.
  4. Avoiding irritants, such as smoke or dry air, which can exacerbate symptoms.

Home Remedies and When to Use Them

While antibiotics are necessary for bacterial infections, home remedies can complement this treatment by easing symptoms. These remedies are particularly useful for managing mild viral infections where antibiotics are not effective.

When to See a Doctor

While both tonsillitis and strep throat might cause discomfort, there are specific signs that indicate a need for immediate medical evaluation:

  • Persistent Fever: A fever that doesn't subside within 48 hours or one that is higher than 101°F (38.3°C) should be evaluated, as it may indicate a more serious infection.
  • Difficulty Breathing or Swallowing: If swelling in the throat makes it hard to breathe or swallow, seek medical care immediately, as these can be signs of severe tonsillitis or strep throat complications.
  • Severe or Persistent Pain: Pain that doesn't improve with over-the-counter pain relievers or that persists longer than 48 hours should be assessed by a doctor.
  • Signs of Dehydration: If you or your child are unable to keep fluids down, this can lead to dehydration, which requires medical attention.
  • Rash: A rash that develops along with sore throat symptoms can be a sign of scarlet fever, related to strep throat, or another serious condition.

Frequently Asked Questions

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Key Takeaways

  • Tonsillitis often begins gradually with a sore throat and cough, whereas strep throat typically starts suddenly with severe throat pain and no cough.
  • Tonsillitis can be caused by both viruses and bacteria, while strep throat is specifically caused by the group A Streptococcus bacterium.
  • Consult a doctor if you have a persistent high fever, difficulty swallowing, severe throat pain, signs of dehydration, or if symptoms persist for more than a week.
  • Tonsillitis caused by viruses typically requires supportive care, while bacterial infections, including strep throat, should be treated with antibiotics.
  • Regular hand washing, avoiding close contact with infected individuals, and maintaining good general health practices can help prevent both tonsillitis and strep throat.
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