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Dr. Andrew Rynne

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hello, i am concerned about a dark grey area on

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Dr. Antoneta Zotaj

General & Family Physician

Practicing since :2004

Answered : 1742 Questions

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Posted on Thu, 24 Jan 2019 in Ear, Nose and Throat Problems
Question: hello,

i am concerned about a dark grey area on my left tonsil. i have recently beeb diagnosed with strep and am on amoxicillin, but the dark area is still there. i do not smoke. i am a 38 year old female. the spot is mostly in the fold of ny tonsil.
doctor
Answered by Dr. Antoneta Zotaj 3 hours later
Brief Answer:
Kindly asked for some more information

Detailed Answer:
Hello,

I carefully read your question and reviewed the uploaded image. It would be helpful for me to better understand what the cause of the dark spot is if I can have some more information on the condition.
- For how long have you noticed the dark spot in your left tonsil?
- When did you start amoxicillin and how many days was it given? Have used it as advised?
- Do you have any pain at the area at the moment?
- Any fever at the moment?
- it seems from the picture that there is a gray area in the base of the tongue as well, is this usual for you?
- Are you otherwise healthy, any other conditions you suffer from and taking treatment for?
- Do you have any runny nose or nose congestion as well?
- Any weight loss or fatigue recently and for how long?

I am waiting to hear from you soon. Please copy and paste my questions in your reply message and answer under each of them so you don't miss any of them.

Kind regards,

Dr. Antoneta Zotaj, General and Family Physician

Above answer was peer-reviewed by : Dr. Vaishalee Punj
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Follow up: Dr. Antoneta Zotaj 5 hours later
- For how long have you noticed the dark spot in your left tonsil? I NOTICED IT A WEEK AGO
- When did you start amoxicillin and how many days was it given? Have used it as advised? I STARTED THE AMOXICILLIN A WEEK AGO, AFTER I NOTICED THE SPOT. IT WAS PRESCRIBED FOR 10 days and I am on day 8. It was prescribed for strep.
- Do you have any pain at the area at the moment? NO PAIN
- Any fever at the moment? NO FEVER
- it seems from the picture that there is a gray area in the base of the tongue as well, is this usual for you? I DIDNT NOTICE IT SO IM NOT SURE
- Are you otherwise healthy, any other conditions you suffer from and taking treatment for? YES I AM HEALTHY
- Do you have any runny nose or nose congestion as well? I CONSTANTLY HAVE CONNGESTION.
- Any weight loss or fatigue recently and for how long? NO

I am waiting to hear from you soon. Please copy and paste my questions in your reply message and answer under each of them so you don't miss any of them.
doctor
Answered by Dr. Antoneta Zotaj 3 hours later
Brief Answer:
Very likely the grey spot is due to the infection and will take a few more days to detach and heal

Detailed Answer:
Hello,

Thank you for the information provided. By what you explain and the picture uploaded, and especially if the doctor that gave you the antibiotic has seen the membrane when examining you and was not concerned, I think the grey area is very likely related to the strep infection. Strep infection can cause secretions and also some damages of the local tissue which can together cause layers on the surface of the tonsils. Especially this being while you have had the infection and it is less then 3-4 weeks supports the fact that this is very likely a self limiting finding.

I would advise you to drink plenty, take the antibiotics as advised and keep a look at the spot. If the spot starts to increase in size or it stays the same size but lasts longer then 3-4 weeks in total then you will need to have a doctor see it.
if the grey spot gets bigger within a few days to weeks it is likely due to diphtheria infection even though this is very rare today due to diphtheria vaccine applied widely. If it grows very slowly and is there after 3-4 weeks the doctor might need to do a good examination and rule out tumor of the tonsil (this is very unlikely in your age and in patients that do not smoke though)

So to conclude:
-very likely the grey area is due to the infection and will take a few more days to totally detach from the tonsil within the next week. If there is no improvement within the next week, this shows the need for review from your doctor.
- in case the spot grows quickly (you notice a change in days to 1-2 weeks) then diphtheria infection, even though less common now a days, needs to be ruled out as it can be serious infection that affects the heart, nervous system and the kidneys.
- if you have not had the routine vaccines of childhood then diphtheria is very important to be ruled out as soon as possible, as this increases the chances of this infection being the cause of the spot. Any worsening in the symptoms or any new symptoms should prompt you to see a doctor soon.
- in case it does not change much but is there in a total of 4 weeks your doctor needs to examine you and consider to rule out a tumor of the tonsil.


I hope I have answered to your query. Please feel free to reply in case more clarification is need on this.

Kind regards,

Dr. Antoneta Zotaj, General and Family Physician
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Antoneta Zotaj 32 minutes later
Thank you! Do you think a medicated gargle would help?
doctor
Answered by Dr. Antoneta Zotaj 11 minutes later
Brief Answer:
Gargles can be tried

Detailed Answer:
Hello,

Gargles might help disinfect the area and may be tried, as long as you are not allergic to the ingredients, they are not going to be harmful so can be tried. You can also use mild salty gargles as well. Having a good mouth hygiene and mouth washes might be important as well.
On the other hand I would not expect the gargles to do a major difference, it is the immune system fighting the infection and the healing of the mucosa that are crucial to clear it and it should be getting better in the next few days. If no improvement, in a few days (maximum a week) or any worsening, you will need to see your doctor (as explained above).

Hope this helps. Let me know if I can assist you further.

Kind regards,

Dr. Antoneta Zotaj, General and Family Physician.



Above answer was peer-reviewed by : Dr. Raju A.T
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