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Suggest treatment for recurring sore throat

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Posted on Tue, 15 Sep 2015
Question: I have a chronic sore throat with round sores with white spots at center. Throat cultures continue to come back negative; the sores are located in tonsil crypts i.e. where tonsils used to be. I have been given antibiotics a number of times; they help; the sores return. This has been going on for years. Yes, I have been to an eye, ear, nose and throat specialist. Yes, I have been to an allergist and an internal medicine doctor, etc.
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Answered by Dr. Naveen Kumar Nanjasetty (3 hours later)
Brief Answer:
Could you please send us a photograph of the tonsils and the throat...

Detailed Answer:
Hi

Thanks for posting the query

I have understood your problem; I'll try my best to help you with this.

Recuurent sore throat could be due to various reasons which needs to be evaluated. Also, it is utmost important to examine the throat to understand your problem, come to a conclusion and suggest any further investigations or remedies. So, if you could kindly send me a photograph of the tonsils and the throat, it will be of an immense help in diagnosing the problem.

Awaiting for your reply...

Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon
Above answer was peer-reviewed by : Dr. Prasad
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Follow up: Dr. Naveen Kumar Nanjasetty (12 minutes later)
I stated that the sores were. Where tonsils used to be. That is I have no tonsils to photograph only the sores in the crypts where they were. I have had trouble getting doctors to get a decent view. I had to take a pen light and aim it at the spot. It would take a very tiny camera with bright flash to get a photograph.
doctor
Answered by Dr. Naveen Kumar Nanjasetty (8 hours later)
Brief Answer:
Recurrent aphthous ulcers...

Detailed Answer:
Hi

Thanks for writing back

My apologies for the confusion. Tonsils contain multiple crypts and in the absence of the tonsils, it's the empty fossa which remains. I do understand it is difficult to take a snap shot of the empty fossa.

The recurrent sores mentioned by you could be the aphthous ulcers. These are noticed in the following conditions:
1. Reduced immunity in the body
2. Stress
3. Vitamin deficiencies
4. Acid reflux disease
5. Smoking
6. Allergy to some food
7. Diabetes, etc.

Most of the times, the recurrent aphthous ulcers are treated using a variety of agents as they are stubborn to the usual line of treatment. In your case, you may require a local infiltration of steroid injection combined with gargles containing steroid and weekly oral Levamisole. Also, you need supportive treatment with multi-vitamins and proton pump inhibitors (if you are having co-existent acid reflux disease).

Avoid taking antihistamines as it is going to dry the oral mucosa and worsen your problem.

I do not want to mention about other causes such as Beh├žet's disease and oral Lichen planus, because your doctors would have already ruled it out.

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
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Naveen Kumar Nanjasetty (10 hours later)
Thank you for this information. I do live under considerable stress and have acid reflux. I also have fibromyalgia. I will take your answer to my primary care doctor to pursue suggested treatment options.
Thank you, XXXXXXX XXXX
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Answered by Dr. Naveen Kumar Nanjasetty (12 hours later)
Brief Answer:
Wish you good health...

Detailed Answer:
Hi

Welcome back

Wish you good health and good luck.

Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
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Answered by
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Dr. Naveen Kumar Nanjasetty

ENT Specialist

Practicing since :2001

Answered : 2515 Questions

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Suggest treatment for recurring sore throat

Brief Answer: Could you please send us a photograph of the tonsils and the throat... Detailed Answer: Hi Thanks for posting the query I have understood your problem; I'll try my best to help you with this. Recuurent sore throat could be due to various reasons which needs to be evaluated. Also, it is utmost important to examine the throat to understand your problem, come to a conclusion and suggest any further investigations or remedies. So, if you could kindly send me a photograph of the tonsils and the throat, it will be of an immense help in diagnosing the problem. Awaiting for your reply... Regards Dr. Naveen Kumar N. ENT and Head & Neck Surgeon