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Q. I have sore throat with scratchy sensation and white patch on tonsils. Please help.

Answered by
Dr. B Vageesh Padiyar
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on Aug 15, 2020

Hello doctor,

I have a sore throat for the past 10 days. It is not so painful, but I still feel a scratchy sensation in my throat. Tonsils are normal. I have got a cheek bite on the same side as well. There is a small red lump on palatopharyngeal arch exactly above my tonsil and a whitish patch on the same tonsil.

I did visit my family doctor twice. He informed me that it is a viral infection and will go away in a few days and asked me to gargle using Betadine mouthwash. I was running frequent bowel movements some four days back, and hence he provided me with oral rehydrating powder and anti-diarrheal medicine. No loose motion now. I do not have any difficulty while eating or drinking. No fever. Only mild joint and muscle aches.

Dr. B Vageesh Padiyar

Otolaryngology (E.N.T)
#

Hi,

Welcome to icliniq.com.

Thanks for providing a detailed history regarding the problem in concern. I did have a look at the photos in detail (attachment removed to protect patient identity). There is absolutely nothing that you need to worry about.

The red lump on the palatoglossal arch is an enlarged lymphoid follicle. We have numerous lymphoid follicles in the oropharynx and nasopharyngeal region and they represent the first line of defense for the body. In fact, your tonsil is itself one of the larger aggregates of such lymphoid follicles. The white patch can be due to constant irritation in the throat or sometimes due to antibiotics as well.

Increase in the size of the lymphoid follicles often represents a recent throat infection and an ongoing infection (which may be bacterial or viral). Your tonsils are moderately increased in size and you do not need to worry about them as well. Soreness in the throat can often exist if there is a residual infection or if there have been reflux issues earlier.

You can consider the following advice.

1. Take tablet Pan D (Pantoprazole and Domperidone) one tablet once daily 30 minutes before breakfast for one week.

2. Do salt water gargles 8 to 10 times a day for one month.

3. Avoid oily spicy and cold food/beverages.

4. Keep sipping on boiled warm water every three hours.

5. Avoid smoking and alcohol consumption as much as possible.

All precautionary measures have to be followed as much as possible to prevent any recurrences. Advice mentioned in the points (two to five) above are extremely important and need to be followed to prevent relapse of symptoms.

I hope this helps.


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Thank you doctor,

Should I take antibiotics for the white patch on tonsil? I do have slight muscle weakness. Is it due to infections or inflammatory action during or post-infection?

Dr. B Vageesh Padiyar

Otolaryngology (E.N.T)
#

Hi,

Welcome back to icliniq.com.

If you have already taken a course of antibiotics earlier, another course is not be required now, as they would not do any good to remove the white patch. The slight muscle weakness is mostly due to post-viral infection. You can take a good multivitamin for the same, and you should be fine in a week or two.

I also forgot to mention earlier that there are a high chance that both the red and white spots might remain even after taking medicines and soreness in the throat resolves. There is nothing that you need to worry about, as it does not represent any cancer or malignancy.


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Thank you doctor,

My family doctor did not prescribe me any antibiotics as of now. Although, I have got a blister of unused Cefixime 200 mg tablets in my first aid shelf. Can I use the same or should you prescribe me with another antibiotic? All I have been doing is occasionally taking a sip of ginger turmeric kadha with honey.

It would be a great pleasure if you prescribe me antibiotics if needed as I doubt it would be a bacterial infection because the same type of soreness was experienced a month back along with slight joint and muscle pain and the same seems to be recurring. I am attaching the photo of isolated red bumps (hardly two or three bumps on thighs, arms, and shoulder) on the skin which I am experiencing. Bumps are not itchy and they come and go in two to three days. Also, please prescribe me a multivitamin tablet to relieve joint and muscle stiffness as well.

Dr. B Vageesh Padiyar

Otolaryngology (E.N.T)
#

Hi,

Welcome back to icliniq.com.

You can take Azithromycin 500 mg one tablet after food for the next five days. This antibiotic can create tummy upsets. If it gets too severe, you can consider taking a probiotic twice daily for the next five days. Do not worry about the bumps on the body, they will disappear.

The multivitamins are given to help recover faster, but usually, it takes a week or two for things to stable. If there is too much muscle pain and stiffness, you can also take tablet Mobizox (Diclofenac, Paracetamol, and Chlorzoxazone) one tablet in the morning and evening after food for five days. Please keep a gap of 40 minutes between medications.

Rest, you can follow all the instructions mentioned in the previous conversations.

I hope this helps.


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Hi Sir,

Today marks the end of 5 day Azithromycin dosage. Although the soreness in throat has subsided a mild scratchy feeling do exist.
Tonsils size is same as before(Moderately swollen). A lymph node under my Jaw which was swollen before beginning with Antibiotic treatment has started to shrink slowly. No cough, No fever. Just slight muscle and joint pain.
Is it normal to still have the scratchy sore feeling back in my throat even after completing the course?
And should I continue taking Mobizox for muscle and joint pain?
Or any new medications should you prescribe?
Pls guide.

Dr. B Vageesh Padiyar

Otolaryngology (E.N.T)
# Hi kunal!

1. Continue doing salt water gargles 8 to 10 times a day for next 1 month

2. Antibiotics can be discontinued. Scratchy feeling will be present and will slowly reduce with time to come

3. The lymph node swelling will also slowly disaspper in few weeks. Even if it doesnt, there is nothing that you need to worry.

4. Mobizox can be continued for next 5 days for muscle and the joint pain.

5. Continue the multivit for next 1 month.

Please follow all the other precuationary measures as discussed earlier in our previous conversations.

I hope this answers your query. Do let me know if there is any doubt regarding the same.

Warm regards.

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