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Q. Why do I have pus leaking in my throat, behind the left tonsil?

Answered by
Dr. Mousam Chattopadhyay
and medically reviewed by Dr. Preetha J
This is a premium question & answer published on Oct 17, 2020 and last reviewed on: Oct 24, 2020

Hello doctor,

I have had some pus leaking in my throat behind my left tonsil for quite some time now, and I had tonsil stones. Sometimes it feels like my throat is closing, and it is hard to breathe. It is hard to swallow and feels like somethings are stuck in my throat like pus or tonsil stones. I feel feverish and hard to open my mouth all the way. I am starting to think that I may have a peritonsillar abscess or quinsy. I cannot figure out where this pus is coming from in my mouth.

Dr. Mousam Chattopadhyay

Dentistry Endodontist


Welcome to

Your tonsils look inflamed, and a tonsil stone is noted on the left tonsil (attachment removed to protect patient identity). Different debris types, such as dead cells, mucus, saliva, and food, get trapped over the tonsil and get calcified. Bacterial infection over the build-up leads to infection and inflamed area that leads to pain, foul smell is sometimes due to pus formation, and there may be difficulty swallowing. Start the medication,

  • Capsule Sporidex 500 mg (Cephalexin 500 mg) one capsule twice daily for five days.
  • Tablet Metronidazole 400 mg one tablet twice daily for five days.
  • Tablet Ibuprofen one tablet twice daily for five days.
  • Capsule Omeprazole one capsule twice daily before meal for five days.
  • Betadine mouthwash, gargle in lukewarm water two to three times a day for a week (Povidone-iodine 2%).

Suppose it is not available, saline water gargle will also be helpful. The Betadine gargle, along with other medicines, will help fight the infection and pain. Later on, if possible, get the stone out by an ENT surgeon, it is a straightforward process, but I would strongly advise not to try doing it yourself or else you might hurt the soft tonsil tissue. I hope it was helpful. It is nothing serious to be worried about. Just start the medication, and you will be fine. Do the lukewarm gargle adding with the mouthwash. The fillings done on the lower right first molar do not look sound, kindly let me know if it is painful. If so, upload an image of that tooth as it might also have trouble. Kindly rate positively and oblige. Let me know if there is any further query. I am here to help in every possible way. I pray for your Good health.

Probable diagnosis:

Tonsil Stones or tonsilloliths over the left tonsil area.

Preventive measures:

Avoid chilled food items and lukewarm gargles as many times as possible.

Regarding follow up:

Follow-up after a week.

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Hi doctor,

Thank you for confirming that.

You know I have been to an ENT, and they did not even find anything, and I have been to numerous doctors who did not either. I know it is something to do with my tonsils. I almost feel like it has spread to my throat. Also, I would forward this to my doctor so she can send my prescriptions. One more question, how were you able to tell? I know you have had plenty of experience, but it just blows my mind that I have had this going on for over a year, and no other doctor has tried to diagnose me with anything. And I feel like my neck is sore and stiff a lot of the time. Thanks for your feedback.

Dr. Mousam Chattopadhyay

Dentistry Endodontist


Welcome back to

The attached image (attachment removed to protect patient identity) showed inflamed tonsils, and since you gave the history of troubled swallowing, soreness, tonsil stone, they all add up. Tonsil stones can even be a size of rice; it looks yellowish. Upon the image, on the left tonsil, it looked so. Small minute tonsil stones are hard to diagnose as being small, they get dislodged easily. Tonsilitis and tonsil stones are quite a common infection after dental infection. Since you did not mention any painful tooth, either that also clears the diagnosis. So, I administered antibiotic prophylaxis and anti-inflammatory along with lukewarm gargle. Start the warm gargle from today, and if you got relieved a bit, that confirms the diagnosis. If the mouthwash is not available, even a saline gargle will also do a miracle. Sure, do pass on the information to your doctor. Start the gargle and medications as soon as possible. I am sure that you will be fine and relieved by the drug, and the throat issue will be resolved once and for all. I hope it was helpful. Let me know if any further query is here to help in every possible way.

Thanks a lot.

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