I get recurrent white patches at the back of the throat with swollen lymph nodes. Why?

Question

Hello doctor,

I am a male of 39 years old. I take 100 mg Sumatriptan when needed. My symptoms are distinct white patches on the back of the throat, persistent swollen lymph node in the neck (for at least a week, possibly longer), slight soreness in throat near the node. No fever but have had headaches.

Throat flared up in soreness about a week ago then subsided though lingered and lymph node has stayed swollen. Preceding this flare-up was a long period of post-nasal drip and feeling something thick in the back of the throat.

Looking at photos of my throat from 2015, it looks like I had very similar white patches on the back of my throat then as well, so it is not clear if they are there permanently or chronically. I cannot find many images online that correspond to this particular shape and pattern of white blotches at the back of the throat. Please advise.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

What you are seeing are enlarged lymphatic channels in the back of your throat (attachment removed to protect patient identity). This condition is called cobblestone throat. It is a term we use to describe irritated throat with visible bumps and lumps at the back. Remember that these bumps are due to enlarged lymphatic tissue in the tonsils and adenoids. These are small pockets of tissue in the back of your throat which when you get irritated due to allergies, postnasal drip or infection can become large and obvious. You do not have strep throat or fungal like picture.

I would suggest trying antihistamine and Tylenol for the next few weeks and see if it improves. If not consult an ENT (ear, nose, and throat) doctor.

I hope this helps.

Thank you.

Answer 2

Hello,

Welcome back to icliniq.com.

Glad to have you back.

Did you take the antihistamine and Acetaminophen? By ENT (ear, nose, and throat) referral, I also meant a direct visual inspection of your throat through a camera, for which you would need an in-person visit.

My suggestion would remain the same that is,

Take the tablet Loratadine or Fexofenadine (one pill daily).
Use one drop of the nasal spray (Fluticasone) in each nostril.
Take the tablet Acetaminophen 1 gm twice daily (if sore throat exists).

I hope this helps. Do revert in case of any further queries.

Thank you.