[21F] With sore throat and tonsil swelling

Patient Description

A 21-year-old female has been experiencing a sore throat for the past 5 days, which came on suddenly. The patient reports swelling in the mouth, specifically on the tonsils, and has trouble drinking or eating. There are also white patches and redness in the throat or mouth. The patient has not had a fever, been exposed to anyone with similar symptoms, or been exposed to any irritants or allergens recently. She has not experienced any swollen lymph nodes in her neck, chest pain, or coughing. However, she has had some difficulty breathing that comes and goes, and has noticed changes in her voice. The patient is currently taking prednisone, which was prescribed for her current symptoms. She smokes or uses tobacco products about once a week but has no other pre-existing conditions or chronic illnesses and is not taking any other medications.

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Arora's Assessment

What might be happening

Based on the information you have provided, here are some possible explanations for your symptoms:

  • Tonsillitis: This is an inflammation of the tonsils, which can cause a sore throat, swelling, difficulty swallowing, and white patches on the tonsils. Tonsillitis can be caused by viral or bacterial infections.

    • Treatment: If it's viral, it usually resolves on its own with supportive care like rest, hydration, and over-the-counter pain relievers. If it's bacterial, such as strep throat, antibiotics may be necessary.
  • Pharyngitis: This is an inflammation of the pharynx, leading to a sore throat and possibly white patches. It can also be viral or bacterial.

    • Treatment: Similar to tonsillitis, viral pharyngitis is managed with supportive care, while bacterial pharyngitis may require antibiotics.
  • Oral Thrush: This is a fungal infection in the mouth that can cause white patches, soreness, and difficulty swallowing.

    • Treatment: Antifungal medications are typically prescribed to treat oral thrush.
  • Allergic Reaction: Although you mentioned no known allergies, sometimes new allergies can develop, causing swelling and difficulty swallowing.

    • Treatment: Avoiding the allergen and taking antihistamines can help manage symptoms.

What you can do

While you should consult a healthcare provider for a formal diagnosis and treatment plan, here are some steps you can take to alleviate your symptoms:

  1. Stay Hydrated: Drink plenty of fluids to keep your throat moist and help reduce irritation.
  2. Gargle with Salt Water: This can help soothe your sore throat. Mix 1/4 to 1/2 teaspoon of salt in an 8-ounce glass of warm water.
  3. Use Over-the-Counter Pain Relievers: Medications like ibuprofen or acetaminophen can help reduce pain and inflammation.
  4. Avoid Irritants: Try to avoid smoking and other irritants that can worsen your symptoms.
  5. Rest Your Voice: Minimize talking to help reduce strain on your throat.
  6. Use a Humidifier: Adding moisture to the air can help soothe a dry or sore throat.
  7. Monitor Your Symptoms: Use MDandMe to journal your symptoms, track your progress, and share your notes with your healthcare provider.

What you should look out for

Seek medical attention if you experience any of the following:

  • Difficulty Breathing: If your breathing difficulties worsen or become constant, seek immediate medical attention.
  • High Fever: A fever over 100.4°F that doesn't go away could indicate a more serious infection.
  • Severe Pain: If the pain in your throat becomes severe and unmanageable with over-the-counter medications.
  • Swelling: If the swelling in your throat or mouth worsens or you notice new areas of swelling.
  • Persistent Symptoms: If your symptoms do not improve or worsen over the next few days.

Remember, while these tips can help manage your symptoms, it's important to consult a healthcare provider for a formal diagnosis and appropriate treatment.

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5 mo ago

People Also Ask


What are the common causes of a sore throat with white patches and swelling?

Common causes of a sore throat with white patches and swelling include tonsillitis, pharyngitis, and oral thrush. Tonsillitis and pharyngitis can be caused by viral or bacterial infections, while oral thrush is a fungal infection.


How can I differentiate between viral and bacterial tonsillitis?

Viral tonsillitis often presents with milder symptoms and may resolve on its own, while bacterial tonsillitis, such as strep throat, can cause more severe symptoms and may require antibiotics. A throat culture or rapid strep test can help differentiate between the two.


What are the potential side effects of taking prednisone for throat inflammation?

Prednisone can help reduce inflammation and swelling, but potential side effects include increased appetite, mood changes, insomnia, and a weakened immune system. Long-term use can lead to more serious side effects.


Can smoking once a week contribute to throat problems like tonsillitis or pharyngitis?

Yes, smoking can irritate the throat and contribute to inflammation, making conditions like tonsillitis or pharyngitis more likely or severe. Reducing or quitting smoking can help improve throat health.


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