The disease usually begins with high temperature and possibly chills, especially in children. The patient complains of a persistent pain in the throat, and pain radiating to the ear on swallowing. Opening the mouth is often difficult and painful, the tongue is coated, and there is a mouth odor. The patient may also complain of headache, thick speech, marked feeling of malaise, as well as swelling and tenderness of the neck glands (lymph nodes). Both tonsils and the surrounding area including the posterior pharyngeal wall are deep red and swollen. Later, whitish spots (follicles) form on the tonsils, hence the name follicular tonsillitis. There is also swelling of the neighboring organs such as the faucial pillars, the uvula, and the base of the tongue.
Chronic tonsillitis refers to repeated attacks of acute tonsillitis.