Chronic and Recurrent Tonsillitis: What to Know

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The tonsils are two pieces of tissue located at the back of your throat. They are similar to lymph nodes and their job is to trap germs and help prevent infection.

However, sometimes the tonsils themselves get infected, swollen, and inflamed. This is known as tonsillitis. These symptoms may also affect the adenoids, similar bundles of tissue higher up in the throat and back of nose, or the lingual tonsils, which are on the lower back part of the tongue.

Sometimes the infection and inflammation happens repeatedly (recurrent) or lasts a long time (chronic).

This article will discuss chronic and recurrent tonsillitis. It will also talk about the kinds of treatment healthcare providers provide for this kind of medical condition.

chronic tonsillitis symptoms

Verywell / Joshua Seong

Types of Tonsillitis

Tonsillitis can be caused by infections such as viruses (cytomegalovirus, herpes simplex, Epstein-Barr) or bacteria such as those that cause strep throat. Tonsillitis occurs more commonly in children than in adults. But it does not usually affect children under the age of two.

Tonsillitis is divided into three types. Each type is defined by how often tonsillitis occurs and how long it lasts:

  • Acute tonsillitis includes cases where symptoms last anywhere from three days to about two weeks.
  • Recurrent tonsillitis occurs when a person suffers from multiple episodes of tonsillitis in a year.
  • Chronic tonsillitis cases have symptoms that hang around for more than two weeks.

A peritonsillar abscess occurs when infection from the tonsils spreads into the tissue of the throat behind the tonsil.

Peritonsillar abscess occurs more commonly in adolescents and adults than in children.

Recurrent Tonsillitis

Recurrent tonsillitis may be diagnosed if a person has tonsillitis multiple times in a year. At first, the infections may respond well to antibiotics. But some people still experience frequent tonsil infections.

At least one study has shown that recurrent tonsillitis runs in families. In other words, if you have family members who have recurrent tonsillitis, you are more likely to have it too.

In children, recurrent tonsillitis is most commonly caused by group A beta-hemolytic Streptococcus pyogenes (GABHS) infections. It is also known as strep throat. Other bacteria are more likely to be the cause of adult recurrent tonsillitis.

Reasons for recurring strep throat include:

  • Strains of the bacteria that are resistant to antibiotics
  • Weakened immune system
  • The possibility that you or someone in your family is a strep carrier (who has no symptoms but can spread the bacteria)

Chronic Tonsillitis

Chronic tonsillitis is more common in adolescents and adults. People who suffer from chronic tonsillitis tend to have ongoing:

  • Sore throat
  • Enlarged tonsils
  • Bad breath, which may be related to cryptic tonsils (pockets in the tonsils where food and debris can accumulate)
  • Enlarged and tender neck lymph nodes

If you have an infection with antibiotic-resistant bacteria or an immune system that doesn't work correctly, you may develop chronic tonsillitis. You may also have an increased risk of developing chronic tonsillitis if you have been exposed to radiation.

Ultimately, the decision to remove the tonsils depends on multiple factors. These factors include:

  • Your symptoms
  • Any complications of tonsillitis you may have
  • How the condition affects your ability to attend work or school


If a bacterial infection is the cause of your tonsillitis, your healthcare provider will prescribe an antibiotic. It's important to take the full course of medication as prescribed to reduce the chances the bacteria will become resistant or come back.

Since the bacteria may be resistant to antibiotics, it may be necessary to try another medication if the first prescription doesn't work.

For pain control, you can use over-the-counter medications such as:

When you first begin treatment for recurrent or chronic tonsillitis, you need to make sure you drink enough liquids. Treating your sore throat will make it easier to drink enough liquid to stay hydrated. If you have signs of dehydration, you should seek medical attention.

Regardless of what is causing your recurrent or chronic tonsillitis, your healthcare provider may also recommend having your tonsils removed. This will likely be the case if you are having five to seven episodes of tonsillitis in a year or you have chronic tonsillitis that doesn't respond to medication.

Choosing to have a tonsillectomy can dramatically reduce the number of times you have a sore throat and need antibiotics in a year. It will also improve your quality of life, especially if your tonsillitis is affecting work or school attendance.


Chronic and recurrent tonsillitis is a medical condition that causes swelling of the pharyngeal tonsils and back of the throat. Sometimes the adenoids and the lingual tonsils swell as well.

Recurrent tonsillitis occurs when you have tonsillitis several times a year. Chronic tonsillitis happens when you have an ongoing sore throat, enlarged tonsils, bad breath, and enlarged lymph nodes. They can be treated with antibiotics, pain relievers, and sometimes surgery to remove the tonsils.

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5 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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