Tonsillitis vs. Strep Throat

By Jennifer Nadel, MD
Medically reviewed checkmarkMedically reviewed
March 24, 2022

Sore throats are very common, but that doesn’t make them less uncomfortable: A sore throat can make it painful to speak or swallow.

And if you’ve got a sore throat, you want it gone—but what’s causing your discomfort? 

Tonsillitis and strep throat are two extremely common infections that may cause a sore throat, especially in children. The two infections can be linked, but they are not the same thing. 

In this article, I’ll discuss the difference between tonsillitis and strep throat, symptoms of each infection, and risk factors for both.

Finally, I’ll talk about treatment and prevention, and discuss when it is time to see a doctor. 

Tonsillitis and Strep Throat: What’s the Difference?

Both tonsillitis and strep throat affect the throat and the tonsils, the two, small round lumps of tissue in the back of your throat. Both infections are extremely common.

Tonsillitis may be caused by bacterial infections, including group A streptococcus (the bacteria that causes strep throat), but is more commonly caused by a viral infection. 

To diagnose tonsillitis, the majority of patients will be physically examined by their doctor. Since strep throat can cause tonsillitis, your doctor will often do a strep test.

If the test is negative, the tonsillitis is likely caused by a virus. In this case, antibiotics are neither necessary nor useful.

The tonsillitis—and symptoms—must run their course, with the help of over-the-counter medications for symptomatic relief, as well as rest and hydration. 

Strep throat is a bacterial infection of the throat and tonsils that is highly contagious. To diagnose strep throat, a rapid strep test can bet.

Results often appear within minutes. If you test positive for strep throat, your doctor will likely prescribe antibiotics.

Symptom relief should appear within 24-48 hours, and the infected individual is no longer considered contagious after 24 hours of antibiotics. 

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Symptoms

Tonsillitis and strep throat may have similar symptoms, though there are a few notable differences.

Symptoms of tonsillitis

Common symptoms of tonsillitis include:

  • Sore throat, sometimes severe
  • Red and swollen tonsils
  • Discomfort or trouble swallowing
  • White or yellow coating on the tonsils
  • Swollen glands in the neck
  • Fever
  • Bad breath

In some cases, individuals may experience stomach pain, ear pain, and a headache.

In babies or children too young to tell you their symptoms, refusal to eat, fussiness, or drooling due to pain swallowing may be signs of inflamed tonsils, but need urgent, in-person medical care. 

Symptoms of strep throat

Strep throat may look like other forms of sore throats and tonsillitis, but some common symptoms of strep include:

  • Sore throat that comes on quickly
  • Pain with swallowing
  • Fever
  • Swollen or inflammation of the tonsils, with white spots or streaks on them
  • Tiny, red spots on the roof of the mouth
  • Swollen or tender lymph nodes in the neck

Like tonsillitis, some may experience nausea, body aches, and headaches when infected with strep throat. Strep throat typically does not present with runny nose or sniffles.  

Risk Factors

Both tonsillitis and strep throat are common and can infect anyone, but both are more common in children.

Strep throat is most common in the late fall and early spring, but can occur at any time of year.

Strep throat is also highly contagious, so children in school settings are more prone to infections given their close proximity to others. 

Treatments and Prevention

Bacterial infections, including strep throat, are usually treated with antibiotics.

For viral cases of tonsillitis, treatment is with over-the-counter pain relievers like acetaminophen (Tylenol) and NSAIDs (ibuprofen, Advil, Motrin).

Some common home remedies include gargling salt water for sore throat, getting lots of sleep, drinking warm fluids, eating soft foods if your throat is sore, and lozenges. 

To prevent both strep throat and tonsillitis, the best thing you can do is practice good hygiene.

This includes washing your hands frequently, coughing and sneezing into your elbow, and not sharing utensils, food, or drinks. 

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When to See a Doctor

If you suspect you or your child may have strep throat or tonsillitis, or they have had close contact with someone diagnosed with strep throat, make an appointment with your doctor.

If left untreated, strep throat can develop into more serious conditions.

If you or your child’s symptoms do not improve, or they worsen, reach out to a doctor for further guidance.

Frequently Asked Questions

What's worse, tonsillitis or strep throat?
Generally speaking, strep throat symptoms tend to be more severe and if left untreated, the possible spread of infection may pose more of a risk to your general health. Both tonsillitis and strep throat present with symptoms that may be mild to severe. They also come with their own set of risks if not treated properly.
Can strep throat or tonsillitis go away on its own?
If your tonsillitis is caused by a viral infection, it will likely go away on its own. Strep throat is caused by a bacteria called group A streptococcus. Treatment with antibiotics may speed symptom resolution and decrease the time you are contagious.
How do I know if my sore throat is tonsillitis?
To receive a diagnosis, your doctor will take a history and do a physical exam. Your doctor may decide a strep test is needed and if so, perform one.

K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

Jennifer Nadel, MD

Dr. Jennifer Nadel is a board certified emergency medicine physician and received her medical degree from the George Washington University School of Medicine. She has worked in varied practice environments, including academic urban level-one trauma centers, community hospital emergency departments, skilled nursing facilities, telemedicine, EMS medical control, and flight medicine.

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