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White spots of throat after being on antibiotics
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ShaynaO posted:
Medical history : I am 24 now but I have had an abscess on my tonsils three different times that I had to go into the hospital and have drained and repeated strep/tonsilitis since I was a kid. I was supposed to have my tonsils out when I was younger but it never happened.

On Saturday (4 days ago) I went to urgent care because my throat (tonsils and uvula) were VERY swollen but there were no white spots and I had a 101.4 temperature. The doctor put me on Levaquin 750mg once daily for 7 days. He said this was a very strong antibiotic and should help. I checked my throat every day, multiple times a day and never saw white spots. But today, after being on the antibiotic for 4 days, white spots have now appeared on my throat/uvula!

Is it common for this to happen? Does this mean the antibiotic aren't working? What should I do?
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Rod Moser, PA, PhD responded:
White spots may not be bacterial. I often see white spots on the throat when patients have viral infections, mononucleosis (mono), or even trapped food particles (tonsilliths) in the tonsils. Less commonly, thrush (a yeast infection) can occur in the mouth....this is white, too. Unfortunately, I have no way of examining your throat to personally common on the white spots you are seeing, but it does not mean the antibiotic was not effective.

Did your medical provider check you for Strep before putting you on antibiotics in the first place. Fever and a red, sore throat in no way implies you need antibiotics. If your symptoms persist, you may need to consider a blood test for mono.
 
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ShaynaO replied to Rod Moser, PA, PhD's response:
No, the doctor did not perform a strep test. After telling him my medical history, he looked at my throat and said "Yep, that's what you have, I don't need to do anything else". I just moved from another state and do not have a provider here yet so that is why I went to urgent care.

If it is Mono, will the Levaquin 750mg take care of it?
 
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Rod Moser, PA, PhD replied to ShaynaO's response:
Nope. Mono is a virus. Viruses do not respond to any antibiotic. If you do have mono, then it will be self-resolving.....there are no specific treatments. As a matter of fact, people how are misdiagnosed with mono and treated unnecessarily with antibiotics often get worse.

I hate when medical provider just peak into the throat and throw antibiotics at you. This is not a good practice. He may as well flipped a coin......
 
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ShaynaO replied to Rod Moser, PA, PhD's response:
OK thanks Dr. Moser for your help. I am starting to feel a little better so hopefully what ever I have is going away. I will begin looking for an ENT in my area so that I can start the process of getting my tonsils removed.

Thanks again!
 
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ShaynaO replied to Rod Moser, PA, PhD's response:
Dr. Mozer, I have a new symptom I want to add. Since Tuesday EVERYTIME I eat or drink ANYTHING my throat burns so bad. I thought at first it was hurting to swallow because of my swollen tonsils but the swelling has gone down and I still have the burning pain. It doesn't matter if what I am eating is cold, warm or hot, when I swallow it feels like my throat is on fire.

Any suggestions?
 
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Rod Moser, PA, PhD replied to ShaynaO's response:
Again, you may need to get an EBV panel and a CBC to check for mono. There are many other things that can cause a sore throat, such as reflux, but first things, first.

Are you taking any anti-inflammatory meds? Gargling? When do you see the ENT or your primary care doctor?
 
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ShaynaO replied to Rod Moser, PA, PhD's response:
I am taking Ibuprofen and gargling. I wasn't able to get an appointment with an ENT until March 14th. But I am on a cancellation list so hopefully I can get in sooner.
 
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Rod Moser, PA, PhD replied to ShaynaO's response:
Don't go to the ENT with the expectation that you will ask for your tonsils to be removed and the ENT will set you up for surgery. It really doesn't work like that anymore.

Stay open. Explain your on-going problems and see what he/she has to say. ENTs are surgeons, and surgeons love to do surgery, but not all issues, like yours, will end up in the operating room.

Let me know what happens after you see the ENT.


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