Brief Answer:
Yellow patch over the tonsil is the slough, due to mouth breathing

Detailed Answer:
Hi

Thanks for posting the query

I have gone through the query thoroughly and understood your problems.

The yellow patch on the tonsils could be the slough secondary to the mouth breathing. This is one of the common symptoms following long standing sinus infection.

Usually, it so happens that, following sinus infection there will be nasal block (causing mouth breathing) and post nasal drip. Mouth breathing causes dryness of the oral cavity mucosa leading to formation of slough over the tonsils. Alternately, infected sinus secretions carry bacteria into the throat thus infecting the tonsils.

Plain amoxycillin alone may not suffice. You would require a combination of amoxycillin and clavulanic acid taken for at least couple of weeks. Also, you would require a mucolytic which can lyse the thick secretions. Saline nasal spray, for the easy clearance of sinus secretions and keeping the nasal mucosa moist and hydrated.

The itchy throat and cough can relieved with following home remedies:
1. Drinking frequent sips of warm water.
2. Doing steam inhalation 2-3 times a day to relieve the nasal and throat congestion, as well as, open the sinuses.
3. Avoid coffee, smoking, chilled food and beverages.

Hope this answers your query; revert back to me if you have any follow up queries.

Regards
Dr. Naveen Kumar N
ENT and Head & Neck Surgeon

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Brief Answer:
Intranasal decongestant or steroid sprays can be tried

Detailed Answer:
Hi

Thanks for writing back

First of all, I would like to reassure you that, it's a harmless slough over the tonsil secondary to mouth breathing. You should stop worrying about the yellow patch and concentrate on the primary cause.

Nasal congestion in the night can be relieved with intranasal decongestant (such as oxymetazoline or xylometazoline) or steroid sprays (such as fluticasone or momentasone). Once the nose and sinuses get cleared, the cough and throat discomfort will automatically cease.

Also, use of saline nasal spray and steam inhalation can hasten the healing process. The antibiotics need to be taken for at least 2 weeks. Even after finishing the complete course of antibiotic, if you still feel symptomatic, then, you need to get an x-ray of the paranasal sinuses done to assess the extent of infection.

If the x-ray shows haziness of the sinuses, then, second line of antibiotics such as cephlosporins have to be started.

Drink frequent sips of warm water. This will keep the throat mucosa moist and reduces the slough over the tonsil.

Hope this clarifies your doubts. Wish you good health.

Regards
Dr. Naveen Kumar N
ENT and Head & Neck Surgeon

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