The symptoms of tonsillitis vary from case to case and may be gradual or sudden in onset. In most cases of tonsillitis, a varying combination of the following symptoms is seen:

Soreness of throat

Difficulty in swallowing or painful swallowing of food and drinks

Pain / discomfort while swallowing saliva

Fever with or without chills

Red and swollen tonsils

White spots (specks or patches) on the tonsils

Enlarged lymph nodes in the neck region

Change of voice

Bad breath, foul breath

Pain in the ears (due to common nerve supply of the back of the throat and ears)

Headache

Malaise, tiredness

Difficulty in taking feeds in babies - this may be the sole indicator in some cases of tonsillitis in infants

In certain cases of tonsillitis, the following symptoms may also be seen:

Runny nose

Cough

Hoarseness

Nausea and vomiting

Skin rash

If left untreated, tonsillitis can lead to the development of any of the following:

Chronic tonsillitis: When infection of the tonsils persists, it leads to formation of small pockets in the tonsils where bacteria thrive for extended periods and lead to chronic tonsillitis. This may further lead to formation of small calcified pieces called tonsilloliths that remain lodged on the tonsils. Tonsilloliths emit a foul smelling, rotten egg like odor (halitosis) which gives rise to bad breath. Patient frequently experiences a foreign body sensation in the back of the throat due to tonsilloliths.

Peritonsillar Abscess: Collection of pus behind the tonsils is called peritonsillar abscess. Patients who develop peritonsillar abscess experience severe pain in the throat and difficulty in opening mouth. This condition can spread to cause life-threatening complications if not attended to promptly.

Enlargement of tonsils (Hypertrophic tonsils): Enlarged tonsils can obstruct breathing leading to snoring and disturbed sleep pattern. Obstructed breathing due to enlarged tonsils can be seen in patients as frequent waking at night, restless sleep, excessive sleepiness during daytime, irritability, etc.