Pus on tonsils


When we speak of the tonsils, which can be seen on both sides of the throat behind the tongue, we mean the palatine tonsils (tonsillae palatinae). They are lymphatic organs and together with the other tonsils (e.g. the pharyngeal tonsil, pharyngeal tonsil) form the lymphatic pharyngeal ring. They are used to detect pathogens in the mouth and throat at an early stage and to prepare the immune system for them. For example, pus on the tonsils often occurs in the course of tonsillitis. One then speaks of tonsillitis or angina tonsillaris, the tonsils turn red and swell up. You also have white pus spots on the tonsils or they are completely pus. Pus is usually a yellowish liquid with variable consistency and is always a sign of an inflammatory reaction in the body. It is a mass of dead white blood cells (mostly neutrophils, a subtype of leukocytes). With a few exceptions, pus is actually always an indication of an infection caused by bacteria.

You can find out more about the topic here: angina


In most cases, pus is a sign of a bacterial infection, but tonsillitis is usually caused by viruses. With a viral tonsillitis, there is initially no pus on the tonsils. If the infection is so severe that the immune function of the tonsils is weakened, bacteria (e.g. pneumococci or streptococci) can spread and grow in the mouth and throat. Other causes of tonsillitis can also be Pfeiffer's glandular fever or scarlet fever, both of which are infectious diseases. White lumps on the tonsils do not necessarily have to be pus, they can also be tonsil stones. These arise in the furrows of the tonsils and are then shed into the mouth. Almond stones are not harmful, but can easily be mistaken for tonsillitis, but the tonsils are not reddened and swollen. Almond stones can be a cause of bad breath.

Read more about the topic here: Tonsillitis or Almond pain


To make a diagnosis, the doctor examines the mouth, nose and throat. Swollen and reddened tonsils that are covered with pus are a relatively sure sign of tonsillitis. The doctor feels the neck for swollen and pain-sensitive lymph nodes. The doctor can also take a throat swab with a long cotton swab so that the responsible pathogens can be precisely determined in the laboratory or using a rapid test. Pfeiffer's glandular fever is diagnosed by detecting Epstein-Barr virus antibodies and an increased number of leukocytes in the blood. Scarlet fever can be differentiated because, in addition to the inflamed, purulent tonsils, there is also inflammation and reddening of the entire throat area and a red-discolored tongue with white dots (strawberry tongue). You also develop a rash. Detection of streptococci that cause scarlet fever solidifies the diagnosis.

Find out more about: Symptoms of tonsillitis

Treatment / therapy

If the tonsils are inflamed and suppurated, it is a bacterial purulent tonsillitis. If this suspicion is confirmed by the doctor's examination and if there is evidence of streptococci, for example, then antibiotics must be used against these bacteria. Primarily penicillin V or cephalosporins are used for this. It is important to fight the bacterial infection so that possible secondary diseases, such as rheumatic fever, can be prevented. If the inflammation is not properly treated and cured, it can develop into chronic tonsillitis. This in turn can lead to kidney, heart and joint inflammation. In order for the medication to work properly, it is important to take it strictly as directed by the doctor. The duration of the intake is also very important, the doctor has ordered a certain period of time and the inflammation has already subsided, should you still take the antibiotics. This is the only way to ensure that all bacteria are completely destroyed.If you also suffer from a fever as a result of the infection, bed rest and adequate fluid intake are important to compensate for the water loss through sweating.

If tonsillitis occurs again and again in the patient or if they swell so much that breathing is even impeded, the tonsils must be surgically removed in many cases. In the so-called tonsillectomy, both tonsils are completely removed. In another variant, the tonsillotomy, only parts of the palatine tonsils are removed and the capsule of the tonsil remains. This operation is mainly used on children and has a lower risk of rebleeding. However, it is performed less frequently than tonsillectomy these days. If an operation is not absolutely necessary, it should be avoided if possible, as the tonsils are important for the defense against pathogens in the throat.

Find out more about: Antibiotics for tonsillitis


In the case of tonsillitis, the first recommended treatment of sore throats is the use of Aconitum napellus 9C (five globules every hour). If there are also swallowing difficulties and fever, you can use Belladonna 9C instead (again, five globules per hour). If the tonsils are also reddened and covered with pus, Mercurius corrosivus 30C promises relief. If you have chronic tonsillitis, you should use Kalium muriaticum 9C (five globules twice a day). There are many other remedies (Eucalyptus, Marum verum, Phytolacca, Calcium iodatum, Arum triphyllum, etc.), all of which are adapted to the most diverse forms of the disease and should be selected accordingly. You can read through the respective remedy descriptions. Homeopathy should be used with caution, however, as there is no correct evidence of its mode of action. Homeopathic treatment should in no case replace a visit to the doctor, especially in the case of fever and sore throat that last longer than three days.

Find out more about the following topics:

  • homeopathy
  • Homeopathy for hoarseness
  • Homeopathy for a sore throat
  • Homeopathic medicines
  • Schüssler salts

Concomitant symptoms

If the pus on the tonsils is caused by a purulent tonsillitis, there are several side effects that the disease brings with it. Because the tonsils and throat are inflamed and swollen, you have difficulty swallowing and a sore throat. The swelling in the neck area can even cause hoarseness and difficulty speaking. The lymph nodes in the head and neck area are swollen and tender. The inflammation and the deposits on the tonsils can cause bad breath. If the inflammation attacks the body too much, it reacts with a fever. Fever is the body's natural defense mechanism to fight the bacteria. In the case of Pfeiffer's glandular fever, the body reacts even more strongly, you develop flu symptoms, feel weak and have pain in the body and limbs. Children may also experience abdominal pain. If the almond coating is caused by tonsillitis in the course of a scarlet fever disease, additional symptoms occur. These include, for example, the strawberry tongue (red, with a white coating) and a rash.

Find out more about: This is how contagious tonsillitis is


Acute tonsillitis can occur at any time of the year and at any age. The course and duration of the disease can vary widely and depend on the type of treatment. In most cases, tonsillitis is easy to treat and goes away in a short time without consequences. With antibiotic therapy, the disease is usually cured after about two weeks. Even if the symptoms go away, the medication must still be taken, depending on the doctor's instructions. If the antibiotics are stopped too early, the germs can trigger a new tonsillitis. In serious cases, if the inflammation is not treated properly and becomes chronic, it can last longer than three months and then lead to further complications.

Read more on the topic: How long does tonsillitis last?

Pus on the tonsils without pain

White coating on the tonsils does not mean tonsillitis. It can also be tonsil stones that can arise in the depths of the tonsils (these are fissured and have deep furrows, so-called crypts). If they are "washed out" by the almonds, they come to the surface. Almond stones are neither painful nor dangerous, they can only cause bad breath. Once you have them, the stones may appear more frequently. For example, they can be suctioned off by an ear, nose and throat doctor. Since they are not dangerous, there is no reason to surgically remove the tonsils.

Pus on tonsils without fever

A tonsillitis does not necessarily have to be accompanied by a fever. Fever is a reaction of the body to infections, it tries to kill bacteria by the increased body temperature. If the infection on the tonsils is only mild, the body does not necessarily react directly with a fever. The inflammation persists locally in the throat and is not fought systemically by the body. If the inflammation is not so strong, the almonds, which are also part of the immune system, can fight the bacteria themselves and regenerate.

Find out more about the topic here: Treatment of tonsillitis

Home remedies for pus on the tonsils

Before you get antibiotic therapy or in addition to it, there are a number of home remedies that can reduce the symptoms. However, they should not replace a visit to the doctor. Warm drinks, for example tea with honey, can help, as honey contains ingredients that are slightly antibacterial. The heat has a pain-relieving effect in the neck area.
Horseradish is also a tried and tested home remedy because it also has an antibacterial effect. To make the tea, horseradish root must be freshly grated and poured over with water. The horseradish tea should steep for about 15 minutes and can then be drunk in small sips. However, you should avoid particularly hot or particularly cold drinks, as the extreme temperatures can irritate the inflamed tonsils and lead to even more pain. Everyone reacts differently, so cold drinks can also have a beneficial effect. The cold causes the throat to swell and also relieves the pain. Just try both and see what works better for you. There is also the possibility of gargling iodine in a mouthwash, it works against inflammation. You can get iodine in pharmacies, otherwise you can just gargle salt water. Another option is to warm the neck from the outside, for example with potato wraps. To do this, you need to boil the potatoes, wrap them in a cloth, and then crush them in it. However, it should also be ensured here that the wrap is not too hot. In addition, you should wear a cloth or scarf, even when sleeping. This keeps the throat warm and helps the immune system work better. Should one express pus on the tonsils?

Also read the article on the topic: Tonsillitis - what helps? and Home remedies for tonsillitis

Should the pus be squeezed out of the tonsils?

Stipples on the almonds can be removed. However, you should not try this with tweezers or other sharp objects, as this can easily damage the tonsils and cause them to bleed. Instead, you can use cotton swabs to help yourself. It is most effective to press gently against the area from the side. Inflamed tonsils are, however, reddened and very sensitive to pain, so extreme caution is required when squeezing them out. The pus can also be removed by the ear, nose and throat doctor.

You can find out more about the topic here: Almond abscess