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Dr. Andrew Rynne
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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Inflamed Tonsil, White Lesions, No Fever, No Headache, No Vomiting, Hurts To Swallow

My left tonsil is inflammed to 4 times its regular size and it is covered in white lesions. With difficultly the lesions can be scraped off, and go quite deep. They leave a small hole. I m on antibiotics, and gargling with baking soda and Tantum Verde, as well as 5mg prednisolone daily. I don t have all the other regular symptoms of tonsillitis (which i ve had many times) like fever, headache, vomiting, etc. I feel alright; it just hurts to swallow. Could it be something other than tonsillitis???
Tue, 15 May 2012
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ENT Specialist 's  Response
Hi and welcome to HCM,

I have gone through your problem with details and read the lines repeatedly.



Your question was "Could it be something other than tonsillitis??? " ---

Ans: YES, It might be "tonsilloliths" (ON chronic tonsillitis).



I will try to explain it -

An inflamed tonsil is very painful and there might be fever associated with it. Simply enlarged tonsils (Bilateral & hurts to swallow) may be signs of chronic tonsillitis (NOT "Acute tonsillitis" which symptoms are same like you have suffered earlier many times. The repeated effects of acute tonsillitis leads to chronic tonsillitis and finally a chronic tonsillitis may lead to tonsilloliths. These are tonsil stones and lies inside crypts of tonsils (deep into tonsils, like you explained). When removed you can see the crypts (small hole, as you mentioned). So, provisionally i think it to be "tonsillolith" on chronic tonsillitis. Seeing is always better then assuming, so you definitely have to take help of your local doctor.

So far treatment part is concerned, tonsilloliths itself needs no treatment other then oral hygiene.

BUT, in your situation, you have difficulty (i.e., hurts) on swallowing (due to enlarged tonsils, may not be inflamed) and also you had repeated previous infections, so i think you will need "tonsillectomy". (It is not done in inflamed tonsils. Inflammation have to subside.) In my personal opinion, antibiotics, baking soda gurgling and prednisolone are absolutely NOT needed. You may do a "povidone iodine" gurgle rather.

I hope that i could draw your attention to the actual problem you are suffering and perhaps convince you with this concise explanation.

I sincerely want you to get rid of your problem very very soon and wish you an early recovery.

Take care and thanks
I find this answer helpful
ENT Specialist Dr. Diganta Kumar Das's  Response
Hi and welcome to HCM,

I have gone through your problem with details and read the lines repeatedly.



Your question was "Could it be something other than tonsillitis??? " ---

Ans: YES, It might be "tonsilloliths" (ON chronic tonsillitis).



I will try to explain it -

An inflamed tonsil is very painful and there might be fever associated with it. Simply enlarged tonsils (Bilateral & hurts to swallow) may be signs of chronic tonsillitis (NOT "Acute tonsillitis" which symptoms are same like you have suffered earlier many times. The repeated effects of acute tonsillitis leads to chronic tonsillitis and finally a chronic tonsillitis may lead to tonsilloliths. These are tonsil stones and lies inside crypts of tonsils (deep into tonsils, like you explained). When removed you can see the crypts (small hole, as you mentioned). So, provisionally i think it to be "tonsillolith" on chronic tonsillitis. Seeing is always better then assuming, so you definitely have to take help of your local doctor.

So far treatment part is concerned, tonsilloliths itself needs no treatment other then oral hygiene.

BUT, in your situation, you have difficulty (i.e., hurts) on swallowing (due to enlarged tonsils, may not be inflamed) and also you had repeated previous infections, so i think you will need "tonsillectomy". (It is not done in inflamed tonsils. Inflammation have to subside.) In my personal opinion, antibiotics, baking soda gurgling and prednisolone are absolutely NOT needed. You may do a "povidone iodine" gurgle rather.

I hope that i could draw your attention to the actual problem you are suffering and perhaps convince you with this concise explanation.

I sincerely want you to get rid of your problem very very soon and wish you an early recovery.

Take care and thanks
I find this answer helpful

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Inflamed Tonsil, White Lesions, No Fever, No Headache, No Vomiting, Hurts To Swallow

Hi and welcome to HCM, I have gone through your problem with details and read the lines repeatedly. Your question was Could it be something other than tonsillitis??? --- Ans: YES, It might be tonsilloliths (ON chronic tonsillitis). I will try to explain it - An inflamed tonsil is very painful and there might be fever associated with it. Simply enlarged tonsils (Bilateral & hurts to swallow) may be signs of chronic tonsillitis (NOT Acute tonsillitis which symptoms are same like you have suffered earlier many times. The repeated effects of acute tonsillitis leads to chronic tonsillitis and finally a chronic tonsillitis may lead to tonsilloliths. These are tonsil stones and lies inside crypts of tonsils (deep into tonsils, like you explained). When removed you can see the crypts (small hole, as you mentioned). So, provisionally i think it to be tonsillolith on chronic tonsillitis. Seeing is always better then assuming, so you definitely have to take help of your local doctor. So far treatment part is concerned, tonsilloliths itself needs no treatment other then oral hygiene. BUT, in your situation, you have difficulty (i.e., hurts) on swallowing (due to enlarged tonsils, may not be inflamed) and also you had repeated previous infections, so i think you will need tonsillectomy . (It is not done in inflamed tonsils. Inflammation have to subside.) In my personal opinion, antibiotics, baking soda gurgling and prednisolone are absolutely NOT needed. You may do a povidone iodine gurgle rather. I hope that i could draw your attention to the actual problem you are suffering and perhaps convince you with this concise explanation. I sincerely want you to get rid of your problem very very soon and wish you an early recovery. Take care and thanks