Difference between Viral and Bacterial Tonsillitis
Difference between Viral and Bacterial Tonsillitis

Tonsils are the tissues containing lymphoid follicles. These are located in respiratory pathways. These are subject to bacterial and viral insults resulting in inflammation called ‘Tonsillitis’. Different viruses which cause this condition include influenza, herpes simplex and cytomegalo virus. Bacterial species include staphylococcus, streptococcus and mycoplasm bacteria. Diagnosis is made with the help of various blood tests, culture and PCR tests. These conditions can completely be cured with medicines. Without treatment, it may progress leading to difficulty in breathing and eating. Duration of the disease varies from three days to one week depending upon causative aspects. Some tissues are present on the posterior of esophagus which is responsible for catching all the germs entering into the body through esophagus but sometimes these tissues may be effected by virus and bacteria. Before going towards difference between viral and bacterial tonsillitis lets first see what they are.

Viral Tonsillitis

Viruses are the most common cause of tonsillitis, second being bacteria. Viral tonsillitis generally affects children. Vague symptoms include pain in the throat, cough, headache and fever. Specific attention must be given if the patient shows severe symptoms or has highly elevated fever. Viral tonsillitis is easily transferred from one person to another so care must be taken to avoid contact with infected person. Diagnosis depends upon complete blood picture, viral serology and PCR. In case of viral infections, treatment is merely symptomatic or supportive which includes anti pyretic e.g. panadol, large amount of fluid intake and physical inactivity.

Bacterial Tonsillitis

Bacterial tonsillitis is caused by different species of bacteria but most common cause is streptococcus bacterial specie. It is type of Bacterial Infection. In the past, there was no treatment for tonsillitis but with the development of antibiotics; the number of deaths due to bacterial tonsillitis is reduced tremendously.  Its symptoms are just the same as that of viral tonsillitis. Its treatment regimen is antibiotic mainly penicillin given in a dose according to age and weight of the patient for approximately ten days.

Viral Tonsillitis VS Bacterial Tonsillitis

Causative agent:

Viral tonsillitis is caused by viruses e.g. influenza, para influenza and syncitial virus.

Bacterial tonsillitis is caused most commonly by streptococcus bacteria.


Viral tonsillitis symptoms include fever, flu, cough and headache.

Bacterial tonsillitis includes the same with addition to presence of pus over the tonsils.

Association with cold:

Viral tonsillitis is not specifically related to cold.

Bacterial tonsillitis is actually a sore throat very similar to cold sore throat. So it is deeply associated with cold.


In Viral tonsillitis the risk factor is less and there is no need of medicines if viral tonsillitis is caused due to cold.

Bacterial tonsillitis is severe as compared to viral tonsillitis because a continuous treatment of 10 days is required. If it not treated properly it can become worst.

Physical signs:

Viral tonsillitis does not cause pus formation.

Bacterial tonsillitis may cause yellow colored pus formation over the tonsils.


Viral tonsillitis is diagnosed through viral serology.

Bacterial tonsillitisis diagnosed through ASO titer.


Viral tonsillitis is treated through medicines for fever,  and large amount of liquids is given. And rest is recommended in order to recover from viral tonsillitis rapidly.

Treatment of Bacterial tonsillitis includes all of the above medicines along with antibiotic medicines.

Conclusion: Tonsillitis is divided into two types depending upon the cause, symptoms and duration. Cause may include viral or bacterial tonsillitis and duration based classification includes acute and chronic types. The disease is commonly specific to one age group that is children but is can also effect elders. Its basic treatment is pharmacological but in chronic and advanced stage, surgical removal of tonsils is required. Whatever the treatment choice may be, it completely resolves the disease in contrast to past when people used to die of it.