Angina (tonsillitis)

If it gets uncomfortably rough in the throat, if it burns deep in the throat and hurts when swallowing, it is often caused by tonsillitis, doctors speak of angina or tonsillitis. Here you will find everything you need to know about symptoms, causes, therapy and self-help for angina.


Tonsillitis, Angina tonsillaris


Woman is examined by a doctor

Angina is the slang term for tonsillitis (tonsillitis or angina tonsillaris). More specifically, it is an inflammation of the tonsils. The tonsils are in the pharynx behind the lateral arches. They are part of the lymphatic pharynx ring. The lymphatic pharynx ring protects the upper respiratory tract from pathogens.

However, if bacteria or viruses (for example in the case of a flu-like infection such as colds or as a result of a weakened body’s own defense) get into the lymphatic tissue and multiply there, the tonsils and the lymphatic pharynx ring swell. Then it gets tight in the throat – hence the name angina. Because the Latin word angina means tightness. Angina can occur on one or both sides and can be acute, chronic or intermittent (recurring).

Medical professionals often use the term angina. A prominent example is angina pectoris , which has nothing to do with the tonsils and the respiratory tract.


Acute tonsillitis is one of the most common infectious diseases . Diagnosing angina is one of the 20 most common reasons for visiting a doctor. Tonsillitis is particularly common in children. To avoid complications, children with angina should be examined by a doctor.


The symptoms of angina are characteristic. It is almost always swallowing difficulties and a sore throat that indicate an tonsillitis. The tonsils turn red and swell. Sometimes they are covered with yellow deposits (fibrin) or yellow-white spots and pus-specks. Mucosal ulcers and bad breath as well as a bitter aftertaste after eating or drinking are also common. The lymph nodes in the jaw and neck area often swell, in addition there is fever , weakness, loss of appetite and headache.

Symptoms of side strand angina

In a side-strand angina , the side strands at the exit of the ear trumpet are inflamed and swollen. Sometimes they even close the connection between the throat and middle ear. This often results in headache and ear pain and an inflammation of the middle ear .

Angina as a symptom of other diseases

If scarlet fever is the cause of the angina, the sore throat and difficulty swallowing are accompanied by the typical scarlet fever symptoms (for example, a reddish, spotty tongue, red cheeks and a pale triangle in the mouth).

In diphtheria angina, the tonsils are dirty-gray and those affected often smell of acetone from their mouths. A barking cough is also impressive.

Whistling glandular fever and herpangina

  • Angina in glandular fever (mononucleosis) is also known as monocyte angina. Adolescents and young adults are often affected. The tonsils are swollen thick and very red with yellowish-white toppings. Severe sore throats, lumpy speech (like having a hot lump in your mouth) and difficulty swallowing as well as upper abdominal pain are indicative symptoms of this angina.
  • Herpangina or Angina herpetica is a virus-related inflammation of the palate. It mainly affects young people. The tonsils are only slightly reddened and slightly swollen, initially the pharynx and palate are covered with whitish-yellow blisters.

Only adults are affected by Angina Plaut-Vincent. Lymph node swellings on the neck and difficulty swallowing, as well as a thick, stinky almond, are indicative symptoms. As a rule, those affected do not feel sick.


Angina is mainly caused by bacteria (especially group A beta-hemolytic streptococci, but also Haemophilus influenzae , pneumococci and staphylococci). Almond infections caused by viruses are less common. Then, for example, herpes viruses or the Eppstein-Barr virus trigger angina. Sometimes you read that angina is caused by colds or flu infections. But that’s not correct. Colds are transmitted by viruses, tonsillitis usually not.

Transmission by droplet infection

People with angina pass on the pathogen via droplet infection, for example by coughing, sneezing, kissing or speaking. The risk of infection is particularly high when the body’s defenses are weakened. In the cold season, tonsillitis is particularly common because heating air dries out the throat and palate. Without the protection of the mucous membranes, the pathogens colonize the throat more easily. They penetrate into the lymphatic tissue and multiply: Angina is the result.


A look in the throat is usually enough for the doctor to recognize angina. To support or differentiate the diagnosis, he can assess the throat, oral cavity, ears, base of the tongue, larynx and nasopharynx as well as the cervical and maxillary lymph nodes. Sometimes tissue sampling and blood tests help to identify the type of tonsillitis.


Mild angina often does not need targeted therapy and heals without consequences within a few days. However, severe tonsillitis or tonsillitis in children should be treated by a doctor.

Drug therapy for angina

Medicinal therapy for angina primarily uses antibiotics as well as painkillers and antipyretic drugs.

Non-steroidal anti-inflammatories and antipyretic agents such as diclofenac , ibuprofen or paracetamol help against fever and pain .

In the case of bacterial tonsillitis, antibiotics (especially penicillin) are usually prescribed. Sometimes the doctor also recommends brushing the throat and palate with Mandel solution (an iodine-iodide-potassium-glycerol mixture). You can also gargle with this antiseptic solution.

No antibiotics on your own

It is not so rare for adults to carelessly reach into the medicine cabinet for infectious diseases such as tonsillitis or colds. There is almost always an antibiotic from previous treatment. You should refrain from self-treatment with antibiotics in any case. With the unnecessary use of antibiotics, you promote the development of resistance. In the meantime, many antibiotics become ineffective due to improper use. The federal government wants to steer against this trend with a model project against antibiotic resistance and targeted education. Antibiotic resistance is the main reason for the multiplication of hospital germs, which 77 percent of all Germans fear.

If your doctor prescribes antibiotics, you should strictly adhere to the dose and not stop the therapy prematurely. Otherwise you give the bacteria the chance to develop resistance to the antibiotic. Antibiotic residues do not belong in the pharmacy cabinet at home, but should be disposed of immediately. Your pharmacy is happy to take back unused medication. With household waste or wastewater, on the other hand, antibiotics get into the environment.

Self help against angina

Basically, the course of an angina is easier if you shift down a gear for the duration of the infection. In the case of mild tonsillitis without fever and a strong feeling of illness, bed rest does not necessarily have to be. It promotes the healing process, however, if you don’t exert yourself too much and sometimes sleep an hour longer.

Drinking plenty helps keep the mouth and throat moist. This relieves the rough throat and also reduces swallowing difficulties. If possible, the room air should not be too dry so as not to promote drying out of the mucous membranes.

Over-the-counter medicines for tonsillitis

You can also relieve the symptoms of tonsillitis with prescription medication.

Throat and throat sprays with active ingredients such as dequalinium chloride, dichlorobenzyl alcohol, hexetidine and tyrothrizine have a disinfecting effect. Sprays and lozenges containing benzocaine or lidocaine have a local anesthetic. Herbal products with the active ingredient bromelain are anti-inflammatory and decongestant .

Although especially lozenges for sore throats are also obese: the active ingredients from the lozenges do not reach the throat so far that they can actually work. But at least they ensure an increased flow of saliva, which moistens the mouth and throat mucous membranes.

Herbal ingredients and teas

The herbal active ingredients anise , cajeput, eucalyptus , fennel , camphor , peppermint or thyme have a soothing and weakly antibacterial effect. Envelopes, washes, baths and ointments with active plant ingredients from the medicinal plants eucalyptus, chamomile, thyme and fennel or neck wraps with lukewarm curd cheese are often perceived as beneficial. Teas with anti-inflammatory herbs such as chamomile and sage can also help with tonsillitis.

Homeopathy and Schüssler salts for tonsillitis

  • Arum triphyllum for angina, runny nose and changes in the oral mucosa
  • Barium carbonicum for heavily swollen tonsils
  • Belladonna and Mercuris solubilis for viral tonsillitis and white-coated tonsils
  • Cantharis vesicatoria for burning pain and irritable patients
  • Phytolaca for all kinds of throat problems, especially if they worsen at night.

No. 12 (Calcium sulfuricum) together with the numbers 3 (Ferrum phosphoricum), 4 (Potassium chloratum), 9 (Sodium phosphoricum) and 14 (Kalium bromatum) should help in particular from Schüssler salts . However, these medicines should only be used if the doctor has ruled out purulent or severe tonsillitis. This is especially true for children.


A strong immune system best protects against tonsillitis. You can read about what you can do for this in the special topic “Healthy through the virus season – How to snip colds and the like”.

Furthermore, you do well to keep the throat always moist. Lozenges and sweets with mucus drugs such as Icelandic moss, drinking a lot (no alcohol) and avoiding dry indoor air help.

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