Sore Throat and Tonsillitis

A sore throat is very common and often follows a viral illness such as a cold or flu-like infection. Tonsillitis refers to inflammation of the tonsils, the small glands at the back of the throat. Symptoms can include discomfort when swallowing, swollen tonsils, fever or generalised aches. Most cases improve without treatment over a few days.

These articles are intended as educational sources, not diagnostic nor taking place of a proper medical assessment. If you need help, please book an appointment with one of our GP’s.

Book a GP appointment

What a Sore Throat or Tonsillitis Is

A sore throat occurs when the lining of the throat becomes irritated or inflamed. Tonsillitis happens when the tonsils become swollen or tender. Common causes include:

viral infections such as cold or flu-like illnesses
irritation from dry air, talking for long periods or mild dehydration
occasional bacterial infections, which are less common

Symptoms of a simple sore throat usually settle within a few days and most cases improve without treatment.

Bacterial Tonsillitis: What It Means

While most sore throats and tonsillitis episodes are caused by viral infections, a smaller proportion are related to bacteria. Bacterial tonsillitis tends to cause more pronounced symptoms, although it cannot be diagnosed reliably by symptoms alone.

Bacterial causes may include:

Group A streptococcus (Strep A) — the most commonly associated organism
Group C or G streptococcus — less common
Other throat bacteria that can occasionally contribute to inflammation

These organisms can irritate the tonsils and throat, leading to more severe pain or persistent symptoms.

It is not possible to confirm bacterial tonsillitis without proper clinical assessment. Most sore throats resolve without antibiotics, even when bacterial organisms are present, although assessment is usually required on an individual basis.

Some bacterial and viral organisms can be associated with sore throat or tonsillitis. The table below lists a few examples that may appear in clinical contexts. Symptoms alone cannot confirm the cause and results always need GP assessment.

Type	Organism	Notes
Bacterial	Group A Streptococcus (Strep A)	Often associated with more pronounced sore throat and tonsil inflammation in some cases.
Bacterial	Group C and G Streptococcus	Less common but can also be detected on throat swabs.
Bacterial	Other throat bacteria	Occasionally seen in people with persistent throat symptoms.
Viral	Rhinovirus, seasonal coronaviruses	Common cold viruses that frequently cause mild to moderate sore throats.
Viral	Adenovirus, Influenza	Can cause more generalised flu-like illness with throat discomfort.
Viral	Epstein–Barr virus	Sometimes associated with prolonged sore throat and fatigue in selected cases.

Common Symptoms of a Tonsillitis

You may experience:

Pain or discomfort when swallowing
A dry, scratchy or irritated throat
Swollen tonsils
White or yellowish spots on the tonsils
Fever or generally feeling unwell
Swollen glands in the neck
Bad breath
Reduced appetite due to discomfort

Mild symptoms often improve within 3 to 5 days.

Common Reasons to Have a Sore Throat Reviewed by a GP

Speak to a GP if you have:

Persistent symptoms lasting more than a week
Difficulty swallowing food or fluids
Recurrent sore throats
High temperature that is not improving
Ongoing swollen glands
Symptoms affecting sleep or your ability to eat normally
Any concerns about the appearance of the throat or tonsils

A GP can review your symptoms, examine the throat if needed, and advise on next steps or treatment options.

Severe Symptoms – Seek Urgent Help

Seek urgent medical care if you develop:

Severe difficulty swallowing or drooling because you cannot swallow
Difficulty breathing
A muffled or “hot potato” voice
Severe neck stiffness
Significant swelling on one side of the throat
Severe dehydration (unable to keep fluids down)
Symptoms that are rapidly worsening

These features may indicate a more serious condition requiring immediate assessment.

Understanding Typical Symptom Patterns

Symptoms suggesting a viral sore throat (common)

throat pain
mild fever
discomfort when swallowing
symptoms after a cold
gradual improvement within a few days

These usually settle without treatment.

Symptoms that may need a GP review

symptoms lasting more than a week
severe throat pain
difficulty swallowing
swollen tonsils with persistent fever
recurrent tonsillitis
swollen glands that are not improving

A GP can guide you on treatment, repeat assessment or further tests if needed.

When Antibiotics May Be Considered

A GP may consider antibiotics in certain situations, usually based on:

symptom severity
fever or significant tonsil swelling
difficulty swallowing
symptoms lasting longer than expected
visible pus on the tonsils during examination
increased risk of complications
recurrent episodes in a short period of time

Antibiotics are not routinely needed for most sore throats because viral infections are far more common.

A GP will make decisions about antibiotic treatment based on individual assessment, as throat appearance alone cannot reliably distinguish viral from bacterial causes.

Recurrent or Severe Tonsillitis

If sore throat episodes happen frequently, continue for long periods or significantly impact day-to-day life, a GP may discuss further options or arrange assessment. These discussions focus on symptom patterns rather than diagnosing any specific condition.

AccessGP work with blood tests to help you

How GPs Assess Sore Throat Symptoms

GPs consider:

duration of symptoms
difficulty swallowing
severity of throat pain
presence of fever
any red-flag features
medical history
response to previous treatments

Most sore throats do not require tests.

Managing infections at AccessGP knowledge base

How Sore Throats and Tonsillitis Are Managed

Management typically focuses on comfort and symptom relief. This may include hydration, simple pain relief, throat lozenges, warm drinks or rest. In some cases, a GP may advise additional treatments depending on symptoms.

A GP can advise on suitable management options based on your symptoms.