White spots in the throat can be concerning. While they can indicate strep throat, they are not exclusive to this bacterial infection. Various other conditions can cause similar appearances, making self-diagnosis difficult. Medical consultation is often necessary to identify the cause and ensure proper treatment.
White Spots and Strep Throat
White spots on the tonsils and back of the throat can be a characteristic sign of strep throat. This infection is caused by the bacterium Streptococcus pyogenes. The white patches or streaks are typically pus pockets, forming from the body’s inflammatory response.
These spots indicate active infection and inflammation. While common with strep throat, they do not definitively confirm a strep diagnosis. Many individuals with strep throat also experience a sudden sore throat, pain when swallowing, and a fever. White spots alone are not enough to distinguish strep from other causes.
Other Conditions Causing White Spots
White spots in the throat can arise from several conditions beyond strep throat. Viral tonsillitis or pharyngitis is a common culprit, where viruses can inflame the tonsils and sometimes lead to white exudates. Unlike strep throat, viral infections often present with cold-like symptoms such as a cough or runny nose.
Infectious mononucleosis, commonly known as mono, is another viral infection that can cause white patches or pus on the tonsils. Mono is caused by the Epstein-Barr virus and frequently leads to severe sore throat, fever, and swollen lymph nodes, especially in teenagers and young adults. The white patches in mono can resemble those of strep throat.
Oral thrush, or candidiasis, is a fungal infection caused by an overgrowth of Candida albicans yeast. This condition typically produces creamy white, raised patches resembling cottage cheese on the tongue, inner cheeks, and sometimes the tonsils or back of the throat. Oral thrush is more common in infants, immunocompromised individuals, or those who have recently taken antibiotics.
Tonsil stones are small, calcified deposits that can form in the tonsil crypts. These appear as tiny white or yellow pebbles on the tonsils and are composed of hardened minerals, food debris, and bacteria. While usually harmless, tonsil stones can cause bad breath, a sore throat, or a feeling of something being stuck in the throat.
A peritonsillar abscess is a pus-filled pocket that forms near one of the tonsils, often as a complication of tonsillitis. This condition causes severe pain, typically on one side of the throat, along with swollen tonsils and lymph nodes. White areas may be visible as part of the abscess, which can also lead to difficulty swallowing or opening the mouth.
When to See a Doctor
Seek medical attention if white spots in your throat are accompanied by concerning symptoms. A severe sore throat, especially one that begins suddenly, warrants evaluation. Difficulty swallowing or breathing are serious symptoms that require prompt medical care.
Other signs indicating a need for a doctor’s visit include a high fever, tender and swollen lymph nodes, or a rash. Persistent symptoms that do not improve after a few days, or throat pain lasting longer than a week, should also be assessed. If there has been recent exposure to someone diagnosed with strep throat, medical consultation is recommended.
Diagnosing and Treating Strep Throat
Accurate diagnosis of strep throat is important to differentiate it from viral infections, as antibiotics do not treat viral infections. The primary diagnostic tool is a rapid strep test, which detects bacterial antigens from a throat swab. If the rapid test is negative but strep is still suspected, especially in children, a throat culture may be performed.
A throat culture involves sending a swab sample to a laboratory to confirm the presence of Streptococcus pyogenes. Results can take 24 to 48 hours. Once strep throat is confirmed, antibiotic treatment is prescribed.
Common antibiotics include penicillin and amoxicillin. Completing the full 10-day course of antibiotics is important, even if symptoms improve quickly. This prevents serious complications like rheumatic fever and post-streptococcal glomerulonephritis, and reduces the risk of spreading the infection. Symptomatic relief can be managed with pain relievers and throat lozenges.