[23F] With recurring left-sided oropharyngeal pain and swelling

What might be happening

Based on the symptoms you've described, there are a few potential diagnoses that could explain your condition. Here are the most likely ones:

1. Chronic Tonsillitis or Tonsil Stones

• Rationale: Recurring swelling and pain in the left tonsil, difficulty swallowing, and the presence of a sore or hole in the tonsil are consistent with chronic tonsillitis or tonsil stones. These conditions can cause persistent discomfort and may not always show up in standard tests like those for strep throat.
• Typical Treatments: Treatment may include antibiotics if a bacterial infection is suspected, or a referral to an ENT (ear, nose, and throat) specialist for further evaluation. In some cases, a tonsillectomy (surgical removal of the tonsils) may be recommended.

2. Peritonsillar Abscess

• Rationale: The sharp pain when swallowing, swelling, and the feeling of fullness in the neck could indicate a peritonsillar abscess, which is a collection of pus near the tonsils. This condition can cause severe pain and swelling and may require urgent medical attention.
• Typical Treatments: Treatment usually involves drainage of the abscess and antibiotics. In severe cases, hospitalization may be required.

3. Mononucleosis (Mono)

• Rationale: Fatigue, night sweats, and swollen tonsils can be symptoms of mononucleosis, a viral infection caused by the Epstein-Barr virus. This condition often causes prolonged fatigue and swollen lymph nodes.
• Typical Treatments: Treatment is mainly supportive, including rest, hydration, and over-the-counter pain relievers. It's important to avoid strenuous activities to prevent complications like spleen rupture.

4. Lymphoma

• Rationale: Persistent swelling in the neck, night sweats, and fatigue could be signs of lymphoma, a type of blood cancer that affects the lymphatic system. While this is less likely, it is important to rule out serious conditions.
• Typical Treatments: Diagnosis usually involves blood tests, imaging studies, and possibly a biopsy. Treatment may include chemotherapy, radiation therapy, or other targeted therapies.

What you can do

Pain and Swelling in the Left Tonsil

• See a Doctor: Given the severity and persistence of your symptoms, it's important to see a healthcare provider as soon as possible. They may refer you to an ENT specialist for further evaluation.
• Home Care: In the meantime, you can try gargling with warm salt water, staying hydrated, and using over-the-counter pain relievers like ibuprofen or acetaminophen to manage pain.

Difficulty Swallowing

• Avoid Irritants: Avoid very cold or hot drinks, as they seem to aggravate your symptoms. Stick to lukewarm or room temperature fluids.
• Soft Foods: Opt for soft foods that are easier to swallow, such as soups, smoothies, and mashed potatoes.

Fatigue and Night Sweats

• Rest: Ensure you get plenty of rest and avoid overexertion.
• Hydration: Stay well-hydrated, especially if you are experiencing night sweats.
• Monitor Symptoms: Keep track of your symptoms using the MDandMe journal. This can help you and your healthcare provider identify patterns and triggers.

What you should look out for

Given the severity of your symptoms and the possibility of serious conditions, you should seek medical care as soon as possible. Reasons to seek care even more urgently include:

• Difficulty Breathing: If you experience shortness of breath or difficulty breathing, seek immediate medical attention.
• Severe Pain: If the pain becomes unbearable or you notice any new, severe symptoms, go to the emergency department.
• Fever or Chills: If you develop a high fever or chills, this could indicate an infection that needs prompt treatment.
• Unexplained Weight Loss: If you notice significant, unexplained weight loss, inform your healthcare provider.

Remember, while I can provide information and suggestions, I am not a doctor. It's important to consult with a healthcare professional to receive a formal diagnosis and appropriate treatment. If you have more questions or need further assistance, feel free to continue the conversation.