Brief Answer:
A swab culture should be done.

Detailed Answer:
Hello,
Thanks for choosing HealthcareMagic for your query dear.
Have gone through your details and i appreciate your concerns.

As per your query answers are-

Sometimes severe sore throat is caused by tonsillitis, an inflammation of the tonsils. Tonsillitis can be caused by viruses or bacteria. While the tonsils job is to help fight infection, the tonsils can also become infected. When they do, the result is tonsillitis and a very painful sore throat(exactly the way you are describing her pain).As pain is very severe a swab from the back of her throat is done to send to the laboratory to see which type of germ is causing your sore throat. After the results of swab culture antibiotics could be prescribed as per sensitivity of bacteria.

Second possibility-A viral infection that affects the salivary glands .Mumps affects the parotid glands, salivary glands below and in front of the ears. The disease spreads through infected saliva.Symptoms include swollen, painful salivary glands, fever, headache, fatigue and appetite loss.

High TLC is suggestive of ongoing infection.

Please attach few high resolution clear pictures of sores with follow up query.

As of now Rx,
Tab Serratiopeptidase 10 mg thrice daily(potent anti inflammatory).
Tab Diclofenac 50mg twice daily.
Start taking a broad spectrum antibiotic like Cefixime 400mg twice daily.

(prescription required)
This will provide you immediate symptomatic relief relief.
However a consultation with ear nose throat surgeon should be done.

Thanks.

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Brief Answer:
follow up.

Detailed Answer:
Hey again Dear patient,
No its most likely due to severe gastritis and acid reflux caused by therapy with steroids.
Use of steroid causes increased acid formation.The acid formed reflux back into esophagus and irritates the mucosa lining this irritation causes severe localised inflammation of esophageal wall.As a preventive measure esophageal cells secrete large amount of mucous to prevent acid in coming in direct contact with esophagus.
Usually we manage GERD with a combination of medication and lifestyle changes. If symptoms persist or are severe, innovative endoscopic and surgical procedures can be done that provide long-term symptom relief.

Use antacids like omeperazole or pantoprazole before meals. In my clinic, I suggest 40 mg before breakfast.

Using motility agents like domperidone 30 mg will help with rapid stomach emptying and decreased refurge or heart burn or vomiting.

Don't lye flat right after meals but take brisk walk or stay upright for almost half an hour after meals.

Avoid spicy, greasy, oily foods as well as fizzy drinks. Avoid too much quantity if hot beverages.

I don't feel TLC is related to reflux.Tlc is related to her initial problem for which she is having antifungals.

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