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Have canker in throat, white spots with puss covering tonsils and cough. Prescribed cefaclor and cough syrup

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I am a 24 year old male.

Around 10 days ago I discovered a canker sore in the back of my throat above the tonsils. I've had a history of canker sores so I wasn't worried at the time. However, several days later I noticed white puss covering my tonsils, several white spots, as well as what looks like inflamed cells in the back of my throat (whitish and red checker pattern on the posterior wall of the oropharynx). I don't have any other symptoms, and other than a very, very mild soreness at times in my throat, I feel perfectly fine.

This coincides with a recent bout of off-and-on sneezing with clear mucus and a post-nasal drip. I've had this before and one doctor once said it was caused by allergies. This has been happening for the past 3 weeks and gets worse at night, while on some days it doesn't happen at all.

At a doctor visit yesterday, the doctor diagnosed me with chronic pharyngitis and said the white spots were lymphoid follicles. The cause was from over-use of the throat (I'm a teacher). He prescribed me Cefaclor tablets and cough syrup. No test were performed other than an CT scan of the throat. I suspect this wasn't a good doctor.

I haven't yet taken any medicine.

Please advice.
Posted Fri, 5 Jul 2013 in Ear, Nose and Throat Problems
Answered by Dr. Sreenivasan Narayana 56 minutes later

I have read carefully your description. I have noticed few things; you are worried about your throat and particularly about any cancerous conditions that could affect you. Also, you seem to have done a lot of research on net or otherwise on medical conditions which can be seen in the usage of your medical terminologies which usually is beyond usual patients vocabulary. If you ask me where I am coming to, I want you to stop worrying first!

White pus on tonsils, mild throat pain on and off over a period of three years, sore throat, episodes of post nasal drip and all corroborate with chronic infection of the throat. In your case it is an acute exacerbation of a chronic tonsillitis and pharynigitis; rightly diagnosed by your doctor. You need not worry and continue the treatment prescribed.

Additionally, I suggest you gargle your throat with warm saline solution (salt water) each time you have a meal for one week. You can also use over the counter pain killers for couple of days if the pain is severe and the doctor has not prescribed one. Do complete the full course of antibiotics given by your doctor. Also, avoid irritation to your throat; if you are a smoker, quit immediately.

There could be many reasons for your recurrrent pharyngeal problems; it could be allergic or due to infection. The condition usually subsides over the years if it is allergic; also identifying the allergen and avoiding it could help. Sometimes, in severe cases which do not seem to subside over the years such as chronic granular pharyngitis intervention is suggested including laser treatment.

Hope this helps. Do let me know if you have any further questions.

Above answer was peer-reviewed by
Follow-up: Have canker in throat, white spots with puss covering tonsils and cough. Prescribed cefaclor and cough syrup 8 hours later
Thank you for the insightful answer.

Just a few follow-up questions.

I've never had this before, let alone for the past 3 years, so can it still be considered chronic?

Also, there is almost zero throat pain. Is this unusual?

I am concerned about the cause for the pharyngeal problems. If it is an infection, could there be a problem with my immune system? Should I schedule another doctor's appointment to try and find out what the cause is?

Thank you for any answer you can provide.
Answered by Dr. Sreenivasan Narayana 32 minutes later
Hi Chan,

My apologies for misreading 3 weeks as 3 years! It does not change the answer that I have given except for the fact that you can ignore the treatment options (such as Laser) suggested for very long standing chronic pharyngitis. Nevertheless, anything above two weeks is considered chronic, although you say that it is only one episode. Sometimes the clinical signs in terms of appearance of the mucosa also suggest if it is chronic.

Nevertheless, you should continue the treatment and use the methods I have suggested additionally. As for as if there is any obvious cause of concern, I do not think you should be worried as, even if it is an infection, it does not mean the body's immunity is weak. You can catch communicable diseases from an infected person even when your immunity is not weak.

Please follow the advice given by me and your doctor. I cannot suggest you not to take another appointment as sometimes second opinions help patients. In fact, your post here itself is one form of second opinion. If you decide to XXXXXXX a doctor, I suggest you get a throat swab done which was missing in your description on what your primary doctor investigated (he/she has done a CT scan, probably to identify the source of your post nasal drip and the conditions of your sinus).

All I can say is that you should take it easy for couple of weeks and follow the advice.

Above answer was peer-reviewed by
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