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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Noticed red and white spots on tonsils, Feeling fatigue and have sore throat. Any ideas?

Answered by
Dr. Naveen Kumar

ENT Specialist

Practicing since :2001

Answered : 2402 Questions

Posted on Sat, 22 Dec 2012 in Ear, Nose and Throat Problems
Question: sore throat for 30+ days, red with white spots on throat and tonsils, fatigue, elevated liver enzymes. Negative rapid strep, negative mono blood test. Still waiting on throat culture. Been on ABX- Amoxicillin 800 mg - 2 times a day for 10 days with no relief. Any idea what this could be?
Answered by Dr. Naveen Kumar 4 hours later

Thanks for the query

The features described by you are of acute granular pharyngitis and tonsillitis. It is good that both strep and monospot tests are negative. Hence, this appears to be antibiotic resistant tonsillo-pharyngitis.

Whitish spots on the pharyngeal wall are the pus pointing lymphoid follicles over the pharyngeal wall and blocked crypts of the tonsils with micro-abscess.

Do not worry! This can be cured with appropriate medications and care. Mild elevation of the liver enzymes can be noticed in long-standing viral infections. Fatigue could be due to the antibiotics and long-standing infection.

My advice to you is:
1. To drink plenty of warm water, this helps in keeping the throat hydrated, improve blood circulation and reduce the throat discomfort
2. To use povidone iodine throat spray 3-4 times a day after food. Povidone iodine is a good topical antibiotic and anti-inflmmatory, hence reduce the duration of the infective process.
3. Try taking alternate antibiotics such as oral cefuroxime or injectable antibiotics (after consulting your doctor)
4. Drink plenty of fresh fruit juice to boost your body immunity and reduce the elevated liver enzymes.acs
5. Avoid smoking/chilled beverages/alcohol till you recover.

Hope I have answered your queries; I will be available for the follow-up queries.

Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

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