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Ask Dr. Bob Your Own Question

Dr. Bob
Dr. Bob, Medical Doctor
Category: Medical
Satisfied Customers: 5118
Experience:  20 Years in Internal Medicine, Neurology and Sports Medicine
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Hello I had really bad tonsillitis exactly a month ago, got

Customer Question

Hello I had really bad tonsillitis exactly a month ago, got prescribed penicillin for 2 weeks, after the course it hadn't fully gone, no symptoms felt fine but had white spots on my tonsils, so was put on another 10 day course.. that 10 days has just finished and can still notice white spots coming back, but no other symptoms.. what could this be? I am really worried its something serious.
Submitted: 3 years ago.
Category: Medical
Expert:  Dr. Bob replied 3 years ago.

Doctor-Bob :

White spots on the tonsils are common findings on exam. Sometimes they are associated with infection, sometimes not. Are the tonsils enlarged? Are they red or raw appearing? Did they swab your throat?

JACUSTOMER-rkrgob4g- :

the right one feels enlarged slightly, there is a slight trace of the white spots coming back, it almost feels like its coming back but inside a gap behind/next to the tonsil. I forgot to mention during the 2 week antibiotic course I occasionally missed some and I also smoked cigarettes and occasionally drank alcohol. They did not swab my throat or test for anything.

Doctor-Bob :

Does the throat hurt at all at this point?

JACUSTOMER-rkrgob4g- :

No

Doctor-Bob :

No fever or chills?

JACUSTOMER-rkrgob4g- :

No, it just feels like the white spots are coming back, the same as the did after the 2 week course..

Doctor-Bob :

Do you have a history of allergies?

JACUSTOMER-rkrgob4g- :

no

JACUSTOMER-rkrgob4g- :

It was a day after I got back from abroad it first started which was a month ago so I'd assume I have caught it from somewhere, but am also incredibly worried reading stuff online about it being something more serious unlying

Doctor-Bob :

There are a couple possibilities here. The most likely is that you have tonsiloliths. These are white accretions of dead cells and debri and possibly food particles and such that form in little pockets of the tonsils (like the depressions in golf balls).

JACUSTOMER-rkrgob4g- :

Yes i am aware of those and have had that before, this feels like tonsillitis coming back though

Doctor-Bob :

They can sometimes dislodge and come out in the saliva, and smell pretty bad but are harmless otherwise.

JACUSTOMER-rkrgob4g- :

My neck near my tonsils is occasionally aching a little bit also

Doctor-Bob :

Well, the other possibility is that you have an infection that was only partially responsive to the penicillin.

Doctor-Bob :

The only way to know this would be to have the throat swabbed, and culture it.

Doctor-Bob :

The lab can then look for the presence of a resistant strain of bacteria.

Doctor-Bob :

Some docs will circumvent this approach and retreat with a broader spectrum antibiotic.

JACUSTOMER-rkrgob4g- :

Ok, what sort of infection could that be? Is this likely a case of needing stronger antibiotics I am just incredibly worried because its been over a month now and have read online it could be V

JACUSTOMER-rkrgob4g- :

leukaemia

Doctor-Bob :

It's not likely to be anything serious given the lack of other symptoms and your age. If it is infectious, it could be a pen-resistant strain of streptococcus. It could also be something atypical like gonorrhea. There is no reason to suspect leukemia.

JACUSTOMER-rkrgob4g- :

Ok, I dont think it is infectious because I have been kissing my girlfriend etc and she is fine.. same reason Im pretty positive it isn't gonorrhea because I have a girlfriend/we're both clean/

Doctor-Bob :

Another consideration in your age group would be mono.

Doctor-Bob :

Mononucleosis, which can cause a persistent sore throat and usually some fatigue, but not much else.

Doctor-Bob :

This is a viral infection that is self limited and treated only with supportive measures...but it can be a spectrum in terms of symptoms and yours could be a relatively mild case with only throat discomfort. Your doc can check you for this with a simple test called "monospot" test.

JACUSTOMER-rkrgob4g- :

If it is mono could the penicillin be prolonging it? would my girlfriend not have caught it by now? are some people immune?

JACUSTOMER-rkrgob4g- :

How long does mono usually last?

JACUSTOMER-rkrgob4g- :

also having looked again, my tonsils are slightly red, they dont hurt though

Doctor-Bob :

good questions...mono typically takes months to resolve...if your girlfriend is carrying it she may have given it to you (it's called the "kissing disease" for good reason), is she was exposed to it in the past she already has antibodies and cannot get reinfected from you.

Doctor-Bob :

None of these conditions are dangerous or serious. You will recover from this with time.

Doctor-Bob :

If you need evidence to be reassured, you should see your doc and ask him or her to test you for these things (e.g. swab your throat and run a monospot test). In addition he can check your CBC (blood counts) to make sure there is no evidence in the blood of infection or immune weakness or anemia, etc.

Doctor-Bob :

Did you have any follow up questions?

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