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Appearance of normal Tonsils and Inflamed Pharyngeal Tonsilitis

Normal tonsils can be small and not visible or quite prominent when checked in a mirror.

When the tonsils are small (as in young babies and in most adults) they are barely visible. Between the age of two and five,the tonsils peak in size and may be large enough to touch each other. It is normal for a young child to have large tonsils, and if they appear normal and are not causing any problem (such as sleep apnea), the size of the tonsils alone is generally not a concern.

If the tonsils are infected with a bacteria, they will usually get large, turn somewhat red, and may have some yellowish-white debris on the surface. This would be called bacterial tonsillitis, which is one kind of sore throat. Appearances can be misleading, since there are some viruses which can make the tonsils look like this or worse. Teenagers with infectious mononucleosis (a condition usually caused by infection with the Epstein-Barr virus) have particularly severe symptoms, with very swollen tonsils covered with debris, yet antibiotics are not needed for this disease. On the other hand, the "strep" bacteria can be present in a normal looking throat. The only way to be sure is to do a throat culture, although there are other tests which may suggest a bacterial infection.


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