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Q. I get recurrent sore throat with swollen tonsils filled with pus. What could this be?

Answered by
Dr. Sagar Ramesh Makode
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on Jun 09, 2020 and last reviewed on: Jun 20, 2020

Hi doctor,

I have been dealing with a recurring sore throat for the past couple of months. My tonsils get sore and swollen with pus and usually, I have a canker sore-like lesion on them as well. I get fatigued with body aches. I took tests for mono and streptococcus but I had neither. I am currently taking Escitalopram and generic Yaz birth control.

Dr. Sagar Ramesh Makode

Cardiology General Medicine Internal Medicine


Welcome to

Now if you are having symptoms at present, then you will need an antibiotic course for it, and treatment of choice is Amoxicillin clavulanate combination for five days. You should also have Betadine gargles four times a day for five days. Presence of pus does mean it is likely a bacterial infection, may not be strep but other bacterias.

Now regarding the preventive aspect, firstly there is no reliable way of preventing it other than tonsillectomy. So you should consider this option if this is becoming troublesome for you.

Now some points which would help to catch the infection are maintaining hand and oral hygiene, avoiding too cold foods which usually precipitates the infection. You should try to identify the triggers which have precipitated the infection last time like cold foods, street foods, or other triggers. You should consider the use of Chlorhexidine mouth wash on a regular basis.

Next thing, you should have Betadine gargles with you. With the earliest symptoms of sore throat, you should start gargling four times a day which would prevent the progression to frank infection. If your diet is not good then you may consider having a course of multivitamins for two weeks, otherwise not necessary.

I hope this helps.

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Thank you doctor,

I have taken that antibiotic before and it worked but it came back again a month later. I will try those mouthwashes though. And I will track my foods.

Dr. Sagar Ramesh Makode

Cardiology General Medicine Internal Medicine


Welcome back to

Yes, antibiotics would help to cure the existing infection, but they will not prevent subsequent infections after antibiotics are stopped. You should observe the relationship between infection and sexual encounters especially if there is oral involvement and if any then mouth wash would be helpful.

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