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White spots on tonsils, strep throat, tonsillitis, removal of tonsils

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General & Family Physician
Practicing since : 2009
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my almost 5 year old has white spote on her tonsils. she has bin fighting something for a while but we don't know what it is. Her doctor has done blood work strep test and everything comes back negative, all except the strep test 2 time it has come back positive but so faintly that he thinks she might have bin a carrier. So he put her on antibiotics and now she has the white marks on the back of her tonsils. what is the next step?
Posted Tue, 17 Apr 2012 in Child Health
Answered by Dr. Vidya Muralidhar 4 hours later

Thanks for your query.

Having white spots on tonsils indicate an underlying throat infection leading to tonsillitis, an inflammation of the tonsils causing redness, white or yellow patches, swelling of the tissues and tonsils as well.

There are many causes for this condition like bacterial infections like spreptococci, staphylococci, e coli infections and viral fevers causing a sore throat.Among all the causes , group A Streptococci are the most common bacterial cause and they are very common in school going children manifesting with sore throat and fever .

I can also think of tonsillar calculi, meaning stones , which are the calcifications in the tonsilar tissue due to chronic and recurrent infections ,it is a combination of swollen glands, excessive mucus and oral bacterial debris, but this is very rare and I will not think of it right now in your child's case.

The heart of the treatment for a tonsillar inflammation and sore throat, mostly streptococci in origin , would be ANTIBIOTICS. It becomes very important to seek immediate attention when ever the child picks up a sore throat and get it treated at the earliest.We must always make sure to give the full course of antibiotics to prevent recurrence and resistance later on. Most often the condition subsides with antibiotics, if they recur and symptoms like fever, cough , body aches, abdominal pain , rashes, etc worsen, then it may need a dose modification or a change in the drug as well.The aim here would be to prevent an abscess or any systemic infections which the tonsillar inflammation can complicate.

If this occurs very frequently , we do a surgery called tonsillectomy to remove the tonsills and control the infection and prevent any complications.

Do not worry about the white marks for now , with the inflammation coming down ,the marks will also begin to fade away.As your child has had antibiotics, if the course is completed correctly, and the child is free of any symptoms , you may wish to wait for a week for things to resolve.

Meanwhile keep him hydrated with good amount of fluids and water intake daily and feed him well with frequent meals. He must take adequate rest and resume his daily activities only after complete recovery. Warm saline gargles for 3 to 4 times a day will relieve the congestion and inflammation , killing the unwanted bacteria too.

You could get back to your doctor for a review on his throat condition and examination, in order to confirm if the infection has completely resolved and whether any medicines have to be continued or not.

I hope i was able to answer your query.I am available for follow up questions as well.
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