What could cause swollen tonsils covered with white layer?

Q. My tonsils are swollen and covered with white layer. What could this be?

Answered by
Dr. Muhammad Zubayer Alam
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on Apr 06, 2020 and last reviewed on: Nov 04, 2022

Hello doctor,

I am a 29-year-old female, 250 lbs. I do not smoke or drink. Tonight while looking at my throat, I discovered my right tonsil is swollen, lumpy, and covered in a thick, white layer of skin. Upon initial inspection, I mistook these white patches for tonsil stones, but they are not. They seem to be stuck to the surface of my tonsil. I managed to scrape some off with a bit of effort. The tissue underneath began to bleed. The white layer appears to be skin. I do not feel sick, apart from allergies (the pollen count is quite high here right now). Any thoughts as to what could be causing this?

I am currently on HCTZ, Metoprolol, Lexapro.



Welcome to icliniq.com.

I can understand your concern. According to your statement, your right tonsil is swollen, lumpy and covered in a white, thick layer of skin. White spots on the tonsils usually indicate an infection. Infections may be due to bacteria, fungus or viruses.

Strep throat is a bacterial infection caused by Streptococcus. Complications include rheumatic fever and ear and sinus infections if infection spread to other parts of the body. Additional symptoms that may indicate strep throat include sore throat, fever, swollen glands in the neck, and headache.

Oral thrush is a fungal infection in the mouth. It can occur in people with a weakened immune system or oral steroid ingestion. White spots may the only symptom of oral thrush but when additional symptoms develop they may include sore throat, pain when swallowing, loss of taste, etc.

Tonsillitis can develop due to viral infections such as rhinovirus, adenovirus, respiratory syncytial virus. Symptoms may include swollen tonsils, painful swallowing, fever, earache, nasal congestion.

Infectious mononucleosis is a viral infection caused by Epstein Barr virus. Along with white spots on the back of the throat symptoms may include fever, sore throat, and fatigue.

You should undergo throat culture, and blood tests indicate if certain antibodies are present which helps identify specific infections. So treatment depends on finding the causative agent which are responsible for your present sufferings and treat them accordingly.

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