Complications of Tonsillitis
Ear, Nose, & ThroatTonsillitis

Complications That Can Result From Tonsillitis

Complications That Can Result From Tonsillitis
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Updated on October 27, 2025
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A viral infection or bacterial infection, like strep throat, can cause tonsillitis. Most of the time, the condition resolves on its own. However, sometimes it can lead to complications that require medical attention. Some symptoms of tonsillitis can also resemble those of more serious conditions, like Ludwig angina or epiglottitis.

If you have tonsillitis that doesn’t get better on its own with at-home management or seems to keep coming back, consult your doctor or healthcare provider to see if you need other treatment.

The most notable risk of tonsillitis is that it can cause you to get sicker and sicker, says James Clark, MBBCh, assistant professor of otolaryngology at Johns Hopkins Medicine in Baltimore. “If you have a true bacterial infection in your tonsils, it works just like any other bacterial infection,” he says.

If bacterial infections do not go away on their own, they can continue to worsen and spread throughout the body. The risks of this are incredibly low, but it’s why you should see your doctor if tonsillitis does not clear up on its own in a week, Dr. Clark adds.

Here are a few other complications that can result from tonsillitis. Note that they are more common in people who have tonsillitis repeatedly or when it becomes chronic.

Tonsillitis Can Cause Sleep Apnea Temporarily — or Sometimes Longer

Obstructive sleep apnea is a condition in which the upper airway repeatedly collapses during sleep. This interruption leads to poor sleep quality and daytime tiredness. It can also significantly affect cardiovascular health and quality of life.

Sleep apnea can result from very enlarged tonsils that prevent normal breathing during sleep. Because tonsillitis can cause the tonsils to become enlarged, it is a potential cause of sleep apnea.

 This can be temporary or permanent, depending on whether tonsillitis is recurrent or causes lasting inflammation in the tonsils.
“During an infection when tonsils are swollen, it can cause temporary sleep apnea,” Clark says. This complication can happen in both children and adults. With children in particular, removing the tonsils (tonsillectomy) may be recommended to cure the sleep apnea, which might otherwise become a chronic problem.

Tonsillitis Can Spread and Become an Ear Infection

In some cases, a tonsil infection can lead to a secondary infection of the middle ear.

The tonsils that are visible behind your tongue when you open your mouth are known as the palatine tonsils. They are just one part of a bigger collection of lymphoid tissue known as the Waldeyer’s tonsillar ring. Other parts include the adenoid, tubal, and lingual tonsils, Clark explains.

 “When we get an episode of tonsillitis, all this tissue increases in size.”
The middle ear is a sealed cavity with only one opening, called the eustachian tube. The adenoid and tubal tonsils are located in the back of the nose and are close to the eustachian tube.

When these tissues become swollen from an infection it can block the eustachian tube and result in pressure buildup in the ear. “This can cause an effusion (or accumulation of fluid) in the ear, which can then get infected,” says Clark.

Tonsillitis Can Cause Peritonsillar Abscess

If strep throat or tonsillitis does not go away on its own or with treatment, either type of infection can progress to tonsillar cellulitis.

In some cases, tonsillar cellulitis can cause pus to accumulate around the tonsils, known as a peritonsillar abscess or quinsy.

 “This abscess in the space behind the tonsil can cause compression of the airway, which is very painful,” Clark explains.
Symptoms of peritonsillar abscess include fever, throat pain, and difficulty swallowing.

 “It’s typically associated with just one side, so we look for asymmetry,” explains Clark. “When this occurs, we have to drain it to help relieve the infection,” he adds.

If Tonsillitis Is Caused by Strep, It Can Cause Rheumatic Fever

If tonsillitis due to a strep infection is not treated, it can develop into a condition called rheumatic fever. This is an inflammatory disorder primarily found in children between the ages of 5 and 15.

Rheumatic fever can affect the heart, joints, and other tissues and sometimes causes permanent damage. Symptoms include sore throat, fever, headache, and muscle and joint aches.

When rheumatic fever damages the heart valve, this is known as rheumatic heart disease. Rheumatic heart disease can affect you for the rest of your life, says Clark. “If your heart has been injured in this way, you'll need antibiotics for any type of surgery where there’s a potential for an infection or sepsis in the blood,” he says. This prevents bacteria from growing into the damaged heart valve, which would cause further damage and issues.

Tonsillitis Caused by Strep Can Also Lead to Kidney Complications

Post-streptococcal glomerulonephritis (PSGN) is an inflammatory disorder of the kidneys. Although rare, it can develop after strep throat, scarlet fever, or impetigo. Anyone can develop PSGN, but it’s more common in children than adults. Signs and symptoms can include protein in the urine, dark or reddish brown urine, and decreased need to urinate.

People with PSGN usually recover in a few weeks without any additional or lasting complications. However, in very rare cases, long-term kidney damage or kidney failure can occur.

Can Tonsillitis Be a Sign of Cancer?

While there is no link between tonsillitis and cancer, sometimes they may have similar symptoms. Tonsillitis that doesn’t seem to go away or causes a chronic sore throat may be a sign of something more serious, such as cancer.

Adults don’t commonly get tonsillitis, so there is a concern that when it does appear, the symptoms may actually be something else masquerading as tonsillitis, says Nicholas Rowan, MD, associate professor of otolaryngology at John Hopkins Medicine in Baltimore.

“If a middle-aged man complains of tonsillitis or reoccurring tonsillitis, I want to be certain their symptoms improve to ensure they don't have an underlying problem, such as throat or tonsil cancer,” says Dr. Rowan. He adds that in general, the symptoms do not end up being cancer. But he says that even if the chances are small, it is important to rule out those more serious complications.

The Takeaway

  • Tonsillitis occurs when the tonsils become inflamed. This can lead to complications like sleep apnea, ear infections, and more severe issues, like a peritonsillar abscess.
  • Most of the time, tonsillitis resolves on its own within a week. Persistent or recurring symptoms may require medical attention.
  • If your symptoms aren’t improving, reach out to your healthcare provider for further guidance.
EDITORIAL SOURCES
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
Resources
  1. Anderson J et al. Tonsillitis. StatPearls. August 8, 2023.
  2. Tonsillitis. Cleveland Clinic. October 12, 2023.
  3. Slowik JM et al. Obstructive Sleep Apnea. StatPearls. March 4, 2025.
  4. Pediatric obstructive sleep apnea: Symptoms and causes. Mayo Clinic. Nov. 06, 2024.
  5. Pediatric obstructive sleep apnea: Diagnosis and treatment. Mayo Clinic. Nov. 06, 2024.
  6. Seleim AM et al. Different techniques of adenoidectomy and its impact on middle ear pressure: a randomized controlled study. European Archives of Oto-Rhino-Laryngology. November 6, 2023.
  7. Peritonsillar Abscess. Cleveland Clinic. April 18, 2022.
  8. MD Sadakat Chowdhury. Acute Rheumatic Fever. StatPearls. February 17, 2025.
  9. About Post-Streptococcal Glomerulonephritis. Centers for Disease Control and Prevention. March 1, 2024.
  10. Jamal Z et al. Oropharyngeal Squamous Cell Carcinoma. StatPearls. April 27, 2023.
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