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White spots on tonsils with mild irritation, treated for strep with amoxycillin, sinus with phlegm. What's wrong ?

I have had white spots on my tonsils for months with mild irritation in my throat. I was treated for strep with amoxicillin and it made the spots go away. They cane back a few weeks later and i was given z-pack. They went away though not completely then reemerged. I have post nasal drip and now a sinus cold with a lot of phlegm and congestion. My tonsils are still sore occassionally and enlarged. They finally tested me for strep and it was negative. I am worried and not sure what is wrong. I have had tonsil stones for a long time and i have large cryptic tonsils but i have never had a problem like this. Any help?
Asked On : Thu, 24 Jan 2013
Answers:  2 Views:  83
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Dentist 's  Response
Hello and welcome to HCM,
After reading to your problem i can suspect you are suffering from Acute tonsillitis. It can be viral or bacterial infection. As you said test for streptococcus is negative, the possible cause would have been viral. Virus like influenza virus, herpes simplex , epstein barr virus , rhinovirus are commonly associated with tonsillitis. Viruses enter through nose and mouth and get filtered in tonsills.
they lead to symptoms like white pus like spots on tonsillar crypts,sore throat, congestion,phlegm ,nasal discharge,swelling and pain.
Penicillin and cephalosporins are used as primary medications,you can do mouth gargling with antiseptic mouth wash like chlorhexidine for soothing effect.
As you said you have tonsil stones ,such chronic cases are treated with tonsillectomy, i suggest you to consult a ENT surgeon who will come up with clinical evaluation and treatment. take care.
Answered: Thu, 24 Jan 2013
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General & Family Physician Dr. Shoaib Khan's  Response
Hello and welcome.

Thank you for your query.

You need to know that there are many causes to a throat infection other than streptococcal bacteria. You could discuss the possibility of the following with your doctor:

-Viral pharyngitis (throat pain+flu-like symptoms)
-Thrush (fungal infection causing white patches on tongue+inside of cheeks)
-Mononucleosis (viral infection causing fever, exhaustion, body rashes, etc.)

And a lot more. If the bacterial cause has been ruled out you could consider other causes like the ones I have listed above)

I hope I have succeeded in answering your questions, you could write back to us anytime for further clarifications.

Best wishes.
Answered: Thu, 24 Jan 2013
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