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Diagnosed with viral infection and sinusitis. Noticed white lines inside cheeks. Looking for solution

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Emergency Medicine Specialist
Practicing since : 2004
Answered : 77 Questions
Dears, I am in my 6th day of what my gp described as a viral infection and sinusitis - ( swalling is better now and am still sneezing and coughing with some back aches). This morning I just realised that on the inside of my cheeks I have 2 white lines - 1 on each side as if the lines are coming from my throat towards my lips and then there are also 2 white spots on my left side of my throat... what causes this please? Thank you
Posted Sun, 28 Oct 2012 in Infections
Answered by Dr. Sujjalaxmi Bharali 3 hours later
Thanks for writing to us.
Well cough takes a while to subside, the frequency should gradually come down. Backache is also common do not worry.
About the 2 white lines on the inside of your cheeks and 2 white spots on the throat what it seems is that you have developed tonsillitis secondary to follicular tonsillitis variant is due to secondary bacterial infection but it is not possible to distinguish bacterial from viral cases clinically .
I would suggest we run a few tests to make sure what we are dealing with. If we are dealing with a bacterial infection, we would need to give you a course of antibiotics.
The following tests would be needed:
1. Complete blood count : To look at the total leucocyte count (TLC) and erythrocyte sedimentation rate (ESR) which increases in bacterial infection.
2. Throat swab for culture and sensitivity: Not for now but to be done later in case your clinical condition does not improve and you need antibiotics.
Here's what you can do to speed up recovery:
1. Saline ( salt water ) gargles thrice daily.
2. Steam inhalation at bed time [ for your sinusitis ]
3. For fever and pain, you may use paracetamol tablets.
4. Diet : Take fluids ( plenty of juices) and soft solid food.
5. Vitamin C is helpful.
This should resolve your problems. In milder form antibiotic is not given but in case these symptomatic therapy does not work then get in touch with an E.N.T. specialist for a thorough clinical examination of throat and antibiotics. Well in that case you also might have to get a throat swab for culture and sensitivity done as mentioned.
Hope I have answered your query. If you have any further questions I will be happy to help.
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Follow-up: Diagnosed with viral infection and sinusitis. Noticed white lines inside cheeks. Looking for solution 25 minutes later
Many thanks doctor. Could I therefore have tonsillitis even though I have no tonsils? They were removed when I was very little. Thank you
Answered by Dr. Sujjalaxmi Bharali 1 hour later

Thanks for your kind information.

1. Well if both your tonsils have already been removed then it is not tonsillitis.

2. Are you having throat irritation as well?
- In case you are having throat pain and irritation then maybe you have developed pharyngitis as sequelae to upper respiratory infection.
- In case you do not have any such problem then I suppose what you mention as spots might be a simple vitamin deficiency syndrome / aphthous ulcers. They are not concerning and will resolve with vitamin C supplementation. Also take ample amount of fruits and fruit juices.

Besides that, the symptomatic treatment that I have already mentioned earlier remains the same. At any point of time if your symptoms worsen do go to an ENT specialist and get a thorough examination done.

Hope this helps. Let me know if you have other concerns.

Above answer was peer-reviewed by
Follow-up: Diagnosed with viral infection and sinusitis. Noticed white lines inside cheeks. Looking for solution 53 minutes later
Hello again, thank you once again for your reply. Yes, both my tonsils have been removed. I do have an irritation in my throat. What I noticed is that the white lines that I have keep going even at the back of my lower lip! My glands at the back of my ears are still swollen. Also I've been taking Sudafen de congestions and found them very helpful. The back of my throat has some red spots too. Thank you once again.
Answered by Dr. Sujjalaxmi Bharali 25 minutes later

Do take the symptomatic treatment. You can continue sudafed de-congestant.

As for painful glands at the back of ear and red spots, I suggest you get the investigations done: Complete blood count, Throat swab for culture and sensitivity.

The basis of getting the culture done is to isolate any invading organism and adequately treat it.

Do keep notice if you have generalised rashes (all over the body) and high grade fever at any time.

Now that your entire symptoms are well described, I think you need to go a doctor and get a thorough clinical examination done.


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