Can Tonsillitis Go Away Without Treatment?

Tonsillitis caused by viruses usually goes away without treatment after a few days, while tonsillitis caused by bacteria is usually treated with antibiotics. Surgery may be used to treat severe cases of tonsillitis.

Tonsillitis is inflammation of the tonsils. The tonsils are masses of lymph tissue located in the back of the throat that are part of the body’s immune system which helps the body fight off infection. 

Tonsillitis caused by viruses usually goes away on its own without treatment within a few days. Treatment is aimed at symptom relief and may include: 

• Drinking plenty of fluids 
• Managing pain
• Hospitalization in severe cases, such as when a patient becomes dehydrated or has an airway obstruction

Viruses account for about 70% of all cases of tonsillitis. Viruses that commonly cause tonsillitis include adenoviruses, influenza viruses, parainfluenza viruses, enteroviruses, Mycoplasma, Epstein-Barr virus (EBV) (the virus that causes mononucleosis), herpes simplex virus (HSV), cytomegalovirus, and the measles virus.

Tonsillitis caused by bacteria is usually treated with antibiotics such as penicillins, cephalosporins, macrolides, and clindamycin. About 15 to 30 percent of tonsillitis cases are caused by bacteria such as group A beta-hemolytic streptococcus (GABHS), which causes strep throat. 

In severe cases, surgery is used to treat tonsillitis: 

• Removal of the tonsils (tonsillectomy) may be indicated in cases such as children who have seven episodes of tonsillitis in one year, or five episodes per year for two consecutive years, or three episodes per year for three consecutive years
• In severe cases of tonsillitis (peritonsillar abscess), the abscesses may need to be surgically drained 

Home remedies to relieve pain and swelling caused by tonsillitis include: 

• Drink plenty of fluids
  • Warm liquids such as soup, or tea with honey and lemon may be soothing
• Eat soft foods if it hurts to swallow
• Gargle with warm salt water (1/4 teaspoon of salt in 8 ounces of warm water)
• Over-the-counter (OTC) pain relievers for pain and fever
  • Acetaminophen (Tylenol) 
  • Ibuprofen (Advil, Motrin)
  • Children under 18 years of age should not be given aspirin due to the risk of a serious illness called Reye’s syndrome
• Suck on throat lozenges or hard candies (lozenges are not recommended for young children; they can be a choking hazard)  
• Use a cool-mist humidifier to moisten the air

Tonsillitis may occur suddenly (acute), or it may be persistent (chronic). Tonsillitis often occurs in children, but is rare in children under two years.

Symptoms of acute tonsillitis include:

• Tonsil redness
• Tonsil swelling
• White or yellow coating on the tonsils
• Sore throat 
• Hoarseness
• Difficult or painful swallowing
• Laryngitis (loss of voice)
• Ear pain
• Swollen or tender lymph nodes in the neck
• Fever
• Bad breath
• Headaches
• Decreased appetite
• Dehydration
• Mouth breathing
• Snoring
• Tiredness
• Lethargy
• Feeling unwell (malaise)

Symptoms of chronic tonsillitis include:

• Chronic sore throat
• Bad breath
• Tonsil stones (clusters of calcifications, or stones, that develop in the tonsil’s craters)
• Persistent tender lymph nodes in the neck
• Obstructive sleep apnea

Symptoms of peritonsillar abscess (severe tonsillitis) include:

• Severe throat pain
• Fever
• Drooling
• Difficulty opening the mouth 
• Voice sounds muffled
• One tonsil is larger than the other