Peritonsillar Cellulitis

Peritonsillar cellulitis is an infection around a tonsil. This infection usually affects just one of the two tonsils. The result is a severe sore throat. Peritonsillar cellulitis can develop at any age. It often develops in individuals who have had frequent sore throats and who have frequently taken antibiotics.


Peritonsillar cellulitis is usually caused by more than one type of germ (bacteria).


At first, it might seem like a regular sore throat. But a sore throat from peritonsillar cellulitis does not go away in a few days. Instead, it gets worse.

  • Early symptoms of peritonsillar cellulitis may include:

  • Fever and/or chills.

  • A throat that is sore on one side only.

  • Pain in one ear.

  • Pain when swallowing.

  • Feeling more tired than usual.

  • Later symptoms may include:

  • Severe pain when swallowing.

  • Drooling.

  • Trouble opening the mouth wide.

  • Bad breath.

  • Voice changes.


In most cases, your caregiver can make the diagnosis by knowing your symptoms, examining your throat and getting a throat culture. Blood samples may also help to determine the cause of your sore throat.


This is not an ordinary sore throat. It is a condition that needs to be treated quickly. If it is not treated, swelling and pus (an abcess) can develop.

  • Peritonsillar cellulitis is usually treated with antibiotics. These infections require oral antibiotics for a full 10 days and/or antibiotics given into the vein (intravenous, IV).

  • Medications may be prescribed for pain or fever.

  • Sometimes, medications that fight swelling (steroids) are prescribed.

  • If an abscess has formed, the abscess may need to be drained.

  • Individuals who have repeated cases of peritonsillar cellulitis may need an operation to remove the tonsils (tonsillectomy).


  • Take antibiotics as directed by your caregiver. Take all the antibiotics, even if you start to feel better.

  • Some pain is normal with this condition. Take pain medication as directed by your caregiver. Do not take any other pain medications unless approved by your caregiver.

  • Gargle with warm salt water. Use 1 teaspoon (5 grams) salt mixed in 1 cup (250 mL) of warm water. Gargle for 30 seconds or more before spitting the solution out. Gargle 3 to 4 times a day or as needed. This may help ease pain and swelling.

  • A liquid or soft food diet may be necessary if it is hard to swallow.

  • It is important to drink fluids. Drink enough water and fluids to keep your urine clear or pale yellow.

  • Do not smoke.

  • Rest and get plenty of sleep.

  • If your caregiver has given you a follow-up appointment, it is very important to keep that appointment. Your caregiver will need to make sure that the infection is getting better. It is important to check that an abscess is not forming.

  • Return to work or school as directed by your caregiver.


  • Your swelling increases.

  • You have difficulty swallowing.

  • You are unable to take your antibiotic.


  • You have trouble breathing.

  • Your pain gets worse even after taking pain medicine.

  • You see pus around or near the tonsils.

  • Your voice changes.

  • You are drooling.

  • You cough up bloody sputum.

  • You are unable to swallow.

  • You have a fever.


  • Understand these instructions.

  • Will watch your condition.

  • Will get help right away if you are not doing well or get worse.