White spots on the throat often indicate an underlying issue. Various infections and common conditions can cause them. Understanding the potential causes and associated symptoms helps determine when medical advice is necessary.
Common Conditions Causing White Spots
Strep throat, a bacterial infection caused by Streptococcus pyogenes, frequently presents with white streaks or spots on the tonsils. It typically has a sudden onset, causing a sore throat, fever, and difficulty swallowing. Swollen lymph nodes in the neck are also common, while a cough is usually absent. The white patches are often pus or exudate on the inflamed tonsils.
Mononucleosis, commonly known as mono, is a viral infection often caused by the Epstein-Barr virus. It can lead to swollen tonsils with white patches or a whitish-yellow covering. Mono is associated with extreme fatigue, swollen lymph nodes, fever, and a sore throat that can worsen over several days. The onset of symptoms for mononucleosis can be slower compared to strep throat, with symptoms appearing 20-50 days after infection.
Oral thrush, or candidiasis, is a fungal infection caused by an overgrowth of Candida albicans yeast. This condition manifests as creamy white, slightly raised lesions that can appear on the tongue, inner cheeks, roof of the mouth, and tonsils. These patches may resemble cottage cheese and can bleed if scraped. Oral thrush is more common in infants, individuals with weakened immune systems, or those who have recently used antibiotics.
Tonsil stones, medically termed tonsilloliths, are hardened calcifications that form in the tonsil crypts, which are small pockets on the surface of the tonsils. These stones appear as small, yellowish-white lumps and are composed of calcified minerals, food debris, and bacteria or fungi. While often not painful, tonsil stones can cause bad breath, a feeling of something stuck in the throat, and sometimes a sore throat or earache.
Aphthous ulcers, commonly known as canker sores, are small, painful, round or oval sores with a white or yellow center and a red border. While not typically located on the tonsils, they can appear on other soft tissues of the mouth and throat. These ulcers can make eating and talking uncomfortable and usually heal on their own within one to two weeks, though larger ones may take longer.
When to Seek Medical Consultation
Seek medical evaluation for white spots on the throat if symptoms suggest a more serious condition. Severe difficulty swallowing or breathing warrants immediate medical attention. A high fever, particularly above 101°F (38.3°C), is another indicator that professional consultation is needed.
Symptoms that worsen over a few days or do not show improvement should prompt a visit to a healthcare provider. Intense throat pain that interferes with daily activities, such as eating or drinking, also signals a need for medical assessment. Joint pain or a rash accompanying the white spots are additional reasons to consult a doctor. Individuals with a weakened immune system, whether due to illness or medication, should seek prompt medical advice if white spots appear. Recurrent white spots on the throat also suggest a need for professional medical evaluation.
Approaches to Diagnosis and Treatment
When white spots appear on the throat, a healthcare provider will typically begin with a physical examination to assess the throat and surrounding areas. They may gently feel the lymph nodes in the neck to check for swelling or tenderness. A throat swab is often performed, especially if strep throat is suspected, which can be tested rapidly or sent for culture to identify bacterial presence. Blood tests may also be conducted, such as for mononucleosis, to measure antibodies to the virus.
Treatment strategies for white spots on the throat vary depending on the underlying cause. Bacterial infections, such as strep throat, are typically treated with antibiotics, and it is important to complete the full course of medication even if symptoms improve. For viral infections like mononucleosis, antibiotics are ineffective, and treatment focuses on supportive care, including rest, hydration, and pain relief.
Fungal infections, such as oral thrush, are addressed with antifungal medications, often in the form of a swishable solution or oral tablets. Benign causes like tonsil stones may be managed with home remedies such as salt water gargles, or they might require simple removal by a healthcare professional if they are bothersome. In cases of chronic or severe tonsillitis, surgical removal of the tonsils might be recommended.