November 22, 2023

Tonsillitis vs Strep Throat: Unveiling the Differences and Pathways to Recovery

BY Medical House Calls

Table of Contents

Tonsillitis and strep throat, both common afflictions of the throat, often share symptoms that can cause confusion in their identification and treatment.

In this comprehensive article, we delve into their distinct characteristics, exploring their causes, symptoms, and the nuances that guide accurate diagnosis and effective pathways to recovery. Understanding the subtle differences between these two conditions is paramount for individuals seeking to manage their symptoms and promote a swift return to health.

What Is Tonsillitis?

Tonsillitis is the inflammation of the tonsils, two oval-shaped pads of tissue at the back of the throat. Viral or bacterial infections can cause the inflammation. 

Causes of Tonsillitis

Common viral culprits include the influenza virus, adenovirus, and the Epstein-Barr virus, while the most common bacterial cause is Streptococcus pyogenes, also known as group A streptococcus.

Symptoms of Tonsillitis

  • Sore throat
  • Difficulty swallowing
  • Swollen and red tonsils
  • White or yellow coating on the tonsils
  • Fever
  • Headache
  • Fatigue

What Is Strep Throat?

Strep throat is a contagious bacterial infection caused by group A Streptococcus bacteria. It is characterized by a sudden and severe sore throat, often accompanied by fever, headache, and the presence of swollen, red tonsils with patches or streaks of pus.

Causes of Strep

Strep throat is contagious and spreads through respiratory droplets when an infected person coughs or sneezes. Strep throat is more common in children, but it can affect people of all ages.

Symptoms of Strep

  • Sudden and severe sore throat
  • Painful swallowing
  • Red and swollen tonsils, often with patches of pus
  • Fever
  • Headache
  • Body aches

Diagnosis and Testing

Diagnosis of Tonsillitis:

  • Medical History:
    • The healthcare provider will inquire about symptoms, including sore throat, difficulty swallowing, fever, and recent illnesses or exposures.
  • Physical Examination:
    • The back of the throat, tonsils, and surrounding areas are examined for signs of inflammation, redness, and swelling.
  • Laboratory Tests (if necessary):
    • Throat Culture: A swab is taken from the back of the throat, and the sample is cultured to identify the infectious agent. This is not always done for routine cases of tonsillitis but may be performed if bacterial infection is suspected.
    • Rapid Strep Test: This test detects the presence of streptococcal bacteria antigens. It provides results within minutes.
  • Blood Tests (if necessary):
    • Blood tests may be conducted to assess overall health and identify signs of a bacterial infection.

Diagnosis of Strep Throat:

  • Medical History:
    • Similar to tonsillitis, the healthcare provider will ask about symptoms, recent exposures, and the duration and severity.
  • Physical Examination:
    • A thorough examination of the throat, tonsils, and adjacent areas is conducted.
  • Laboratory Tests:
    • Throat Culture: A swab is taken from the back of the throat, and the sample is cultured to identify the presence of the bacteria.
    • Rapid Strep Test: This test detects streptococcal antigens and provides results in a short time, allowing for prompt treatment if necessary.

Treatment Options

Treatment of Tonsillitis

Treatment for tonsillitis depends on the underlying cause. Viral infections often resolve with supportive care such as rest, hydration, and over-the-counter pain relievers. Bacterial infections may require antibiotic therapy.

Treatment of Strep

The primary treatment for strep throat involves a course of antibiotics. These medications eliminate the group A streptococcus bacteria. It is essential to complete the full prescribed course of antibiotics to ensure complete eradication of the bacteria.

Complications and Risks


  1. Peritonsillar Abscess: Severe or untreated cases of bacterial tonsillitis can lead to the formation of a peritonsillar abscess, a collection of pus near the tonsils, causing significant pain and difficulty in swallowing.
  2. Chronic Tonsillitis: Recurrent or persistent cases of tonsillitis can contribute to the development of chronic tonsillitis, characterized by persistent inflammation and recurrent infections, impacting overall health and quality of life.
  3. Enlarged Tonsils: Prolonged inflammation can lead to the enlargement of the tonsils, causing breathing difficulties, especially during sleep, and contributing to conditions like sleep apnea.

Strep Throat:

  1. Rheumatic Fever: If untreated, strep throat caused by group A streptococcus bacteria can cause an inflammatory condition affecting the heart, joints, skin, and nervous system.
  2. Post-Streptococcal Glomerulonephritis (PSGN): This rare complication can cause kidney inflammation, leading to symptoms such as blood in the urine, swelling, and high blood pressure.
  3. Scarlet Fever: Some cases may result in scarlet fever, characterized by a red rash on the skin, high fever, and a strawberry-like appearance of the tongue.

When to See a Healthcare Provider

It is advisable to see a healthcare provider if you suspect you have tonsillitis or strep throat, especially if you experience the following symptoms or circumstances:


  • Persistent or Severe Symptoms: If you have a sore throat for over a few days, it is accompanied by significant discomfort, difficulty swallowing, or other concerning symptoms.
  • Fever: Presence of a high fever, particularly if it is persistent or accompanied by other symptoms.
  • Difficulty Breathing: If enlarged tonsils are causing difficulty in breathing, especially during sleep.
  • Recurrent Infections: If you have a history of recurrent tonsillitis or your symptoms are becoming more frequent.

Strep Throat:

  • Severe Sore Throat: If you have a severe sore throat, especially if it is accompanied by pain while swallowing.
  • Fever: The presence of a high fever, which is a common symptom.
  • Swollen Tonsils with White Patches: If you observe swollen tonsils with patches of pus.
  • Headache and Body Aches: Symptoms such as headache, body aches, and fatigue that accompany the sore throat.
  • Exposure to Strep: If you have been in contact with someone diagnosed with strep throat.

General Guidelines:

  • Persistent Symptoms: If symptoms persist or worsen, seeking medical attention is important.
  • Complications: If you experience difficulty breathing, persistent high fever, or the development of a peritonsillar abscess.
  • Children: Parents should seek prompt medical attention for children with tonsillitis or strep throat symptoms, especially if the child cannot eat or drink due to pain.
  • Known Health Conditions: Individuals with pre-existing health conditions or weakened immune systems should consult a healthcare provider.

Schedule an Appointment with Medical House Calls

Distinguishing between tonsillitis and strep throat is crucial for effective diagnosis and treatment. Tonsillitis, characterized by inflammation of the tonsils, can result from viral and bacterial infections, whereas the latter involves the group A streptococcus bacteria. Prompt medical attention is essential to prevent complications. 

If you experience persistent symptoms, severe sore throat, or have concerns about your health, seeking professional medical care is vital. To schedule an appointment, text or call Medical House Calls at (615) 838-2375. Same-day and next-day appointments are available, ensuring timely and convenient access to healthcare.