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Sore tonsils while swolling, spots on tonsils. What could it be?

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ENT Specialist
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I have had a sore right tonsil the past couple days when I swallow. The rest of my throat is not sore but there are some white spots on both of my tonsils. The left tonsil, however, does not hurt. I do not have a fever or any other symptoms really. Any idea what it could be?
Posted Tue, 22 May 2012 in Ear, Nose and Throat Problems
Answered by Dr. Sumit Bhatti 2 hours later

Thank you for your query.

1. The appearance, size, exact location of the spots, behavior, growth rate or a close up image will help give a better understanding. You may share a close-up image here.

2. When we swallow, our palatine tonsils rub against the food bolus and pick up food particles. This food debris decays there while it is analysed for antigens, foreign bodies and organisms by the lymphoid tissue which forms the bulk of the tonsils. Below the age of five years, this is especially important in the deveopment of immunity.

3. These spots are concretions of food particles and pus lodged in the natural crypts of the palatine tonsils. The white discharge is sometimes referred to as 'cheesy' or even 'toothpaste' like in consistency. The largest crypt is known as the crypta magna and is located near the upper pole of the palatine tonsil. Long standing concretions are known as Tonsilloliths.

4. This is what the tonsils are designed to do. The soreness is due to the mild infection that ensues. If fever develops, it is an infection. If there are no other symptoms, treatment is not a necessity. Allergy and Post-Nasal Drip (PND) may also lead to a similar situation.

6. The simplest course of action will be a course of antibiotics, anti-allergics, anti-inflammatory agents and medicated gargles. A throat swab may be taken for bacterial culture and antibiotic sensitivity. Fungal infections should also be ruled out.

7. At your age, it is unlikely to be anything besides tonsillar tissue activity, infection or allergy.

I hope that I have answered your queries. If you have any further questions, I will be available to answer them.

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