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jbmd
jbmd, Board Certified Physician
Category: Medical
Satisfied Customers: 615
Experience:  Board Certified physician in Internal Medicine - 30+ years experience
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White pus on my tonsils, again!

Customer Question

Hello, I've had white pus on my tonsils quite often since Sep 2012. On September 2012 I did a lab test and it tested negative for streptococcus. The doctor told me I had an elevated number of the natural bacteria that lives on my throat and that I may have gotten white pus from breathing in a lot of dust ( I did some ATV off road racing ).


 


Since then, I've had a sore throat with white pus at least 5 times... However, I noticed, that the last time I had a sore throat I was in a smoking room for about 5 hours, and I even smoked a cigar myself. I deducted that the pus / sore throat could have been caused from cigarette smoke. It has been 1 month now, and today, I woke up with a couple of white dots on my right tonsil.


 


Yesterday, I went to a karaoke bar, there was no smoking and I drank about 800ml of beer. (not a huge amount). Could this be a cause for me having white spots on my throat, yet again? Or should I do another strep test... I do not really want to do another test because I am in a country where it will cost a lot and would rather avoid it if possible. Is it normal to keep getting white pus over your tonsils this often? Thanks

Submitted: 3 years ago.
Category: Medical
Expert:  jbmd replied 3 years ago.

jbmd :

Hi-I'll try to help you. My answer will be advice only and won't replace local medical care from your doctor.

jbmd :

When you have allergies or recurrent infections, tonsils swell as they are lymph glands.

jbmd :

When it happens often enough, scar tissue builds up and little crypts (like tiny caves) form and food and germs get trapped in them, the germs eating the food particles (which can be nearly microscopic)

jbmd :

Non-strep tonsillitis results. If it happens often enough, you get annoying chronically swollen and scarred tonsils. There is no cure for these recurrently-infected crypts but to take the tonsils out--the scar tissue no longer works as protective lymph tissue anyway.

jbmd :

Using antibiotics over and over again for this is not good as they lead to superbugs and can lead to diarrhea and other side effects.

Customer :

Is there no other way than to take the tonsils out?

jbmd :

I don't recommend routine tonsil removal but if a patient has >5 tonsil infections/year with loss of work, then I do

jbmd :

You can be sometimes taught to press the pus out of the tonsils with the back of your toothbrush but sometimes the scarring's too much

jbmd :

and you have to overcome gagging and not choke yourself.

Customer :

so if i were to get it once a month, but not lose work hours, then technically its okay to keep them like this, right?

jbmd :

Rinsing a lot with warm salt water and gargling helps

jbmd :

If it's only an annoyance and not risky to your health (going on to spreading infection) or work life and you can put up with the bad breath (gargle with mouthwash like Listerine after the salt water) then you don't need them out. It would then be up to you

Customer :

okay, this helps a lot, thank you

Customer :

if I go see a doctor here now, Im in germany, I will be able to understand better what the doctors here say

Customer :

thanks a lot have a great day!

jbmd :

Basically if it's bad enough your sinuses are gone anyway. NO SMOKING! Have the doctor make sure there are no growths on your tonsils when you go in for checkups, if you smoked

jbmd :

Not sinuses! tonsils! Sorry.

jbmd, Board Certified Physician
Category: Medical
Satisfied Customers: 615
Experience: Board Certified physician in Internal Medicine - 30+ years experience
jbmd and 2 other Medical Specialists are ready to help you
Customer: replied 3 years ago.

Sorry, you wrote some more stuff after I logged off - by "growths", you mean tonsil stones? http://en.wikipedia.org/wiki/Tonsillolith


 


I will go see a doctor tomorrow, thanks again for all the information as it will help me get better quality treatment rather than just a prescription.

Expert:  jbmd replied 3 years ago.

stones or, in a smoker, tumors. But your doctor has looked and seen nothing, right? Stones are simple concretions of gunk, stuck in the crypts.

 

 

Customer: replied 3 years ago.

The last time the doctor looked at them was 6 months ago, I understand fully though, I will make sure to bring it up when I visit the doctor later this week.


 


Thanks again.

Expert:  jbmd replied 3 years ago.

I doubt a tumor grew in the past six months but I always looked in everyone's throat each physical exam especially in smokers. It's easy and cheap to say "Open wide!"

 

And you're young so it's even less likely you have enough smoking history! (I also worked where cowboys chewed a lot of tobacco! Even worse in the mouth than smoking)

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