What’s the difference between strep throat and tonsillitis?

What’s the difference between strep throat and tonsillitis?

Tonsillitis and strep throat are both throat infections that you might have heard of. While quite common in small children, they can affect anyone at some point in their life[1,2]. These infections both cause pain and swelling of the throat, but how exactly do they differ?

What are the main differences between strep throat and tonsillitis?

  • Streptococcus bacteria causes strep throat

One of the main differences between strep throat and tonsillitis is the bacteria that causes the infection. Strep throat can only be caused by a type of Group A streptococci known as streptococcus pyogenes bacteria[2]. If you were to have a sore throat, but this kind of bacteria wasn’t present, then you likely wouldn’t have strep throat but another sort of infection, such as the common cold, tonsillitis or glandular fever.

It’s important that you understand what is causing your sore throat before taking any treatments. For instance, antibiotics wouldn’t work for an infection that’s caused by a virus. As strep throat is a bacterial infection, however, antibiotics may work to treat it

  • Multiple types of bacteria or viruses can cause tonsillitis

Unlike strep throat, which is only caused by the streptococcus bacteria, tonsillitis can be caused by multiple types of bacteria or viruses. In fact, tonsillitis is most commonly caused by a virus, such as rhinovirus, flu virus and Epstein-Barr virus[1]. The latter can also cause glandular fever (or mononucleosis)[3]

For this reason, you can actually have tonsillitis and another infection at the same time. You can have tonsillitis and strep throat together if the streptococcus bacteria is present, as well as an infection, such as the flu virus, that causes tonsillitis. 

  • Strep throat causes red spots on the roof of the mouth

The other main difference between strep throat and tonsillitis is the symptoms. Generally, strep throat symptoms are as follows[2]

  • Small red spots on the roof of your mouth
  • Sore throat
  • Swollen tonsils with white pus present
  • Enlarged lymph nodes in your neck
  • Pain when swallowing
  • High fever

While you can get some of these symptoms with tonsillitis too, the one that stands out from the others is the spots in your mouth. These red spots won’t be present with tonsillitis, so it’s more likely that you have strep throat[1].

To soothe a sore throat that’s caused by strep throat, you can try a throat lozenge that contains anaesthetic that temporarily numbs the area for fast relief. 

  • Tonsillitis causes inflammation of the tonsils

The symptoms of tonsillitis are very similar to those of strep throat, including swollen tonsils, fever and pain when swallowing, so it can be hard to tell which throat infection you have. Generally, the symptoms of tonsillitis can be less severe[1]

With strep throat, your swollen tonsils will likely have white pus on them, but this is uncommon with tonsillitis. You may also have a fever with both infections, but the fever tends to be lower with tonsillitis[1,2]

Is strep throat tonsillitis?

Strep throat is a type of tonsillitis, because they can both be caused by the same bacteria. However, you can get tonsillitis from other viruses and bacteria too. This means you can have strep throat and tonsillitis together, but tonsillitis isn’t a type of strep throat. 

Can you get strep throat without tonsils?

You can still get strep throat even if you don’t have tonsils, however, this could make the infection a little less severe than people who do have their tonsils[2].


[1] https://www.nhs.uk/conditions/tonsillitis/

[2] https://www.nhs.uk/conditions/strep-a/

[3] https://www.nhs.uk/conditions/glandular-fever/