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Is It Normal To Have White Lines On Tonsils Of Children?
Question: Hello,
My 3 year old son seems to always have white on his tonsils. Often what looks like white lines, and other times white patches. Strep tests come back negative mostly. He recently had strep throat about 3 weeks ago, and again last night large white patches on tonsils. No fever, and feels fine running around...he also has a hypersensitivity to penicillin, macrolides, and most recently cefalexin so we don't and cant really put on meds all the time...is it normal to have white on tonsils most of the time?
My 3 year old son seems to always have white on his tonsils. Often what looks like white lines, and other times white patches. Strep tests come back negative mostly. He recently had strep throat about 3 weeks ago, and again last night large white patches on tonsils. No fever, and feels fine running around...he also has a hypersensitivity to penicillin, macrolides, and most recently cefalexin so we don't and cant really put on meds all the time...is it normal to have white on tonsils most of the time?
Brief Answer:
Could be normal if no other symptoms are present.
Detailed Answer:
Hi.
Thank you for your query.
1. If he has prominent crypts which are normally present on the surface of the tonsil, it is possible that this may just be normal food debris. Upload close-up images, if possible otherwise get his throat & neck examined in detail.
2. The tonsils scrape against the food bolus as we swallow and pick up food derbris to analyse for developing immunity. This function is important till the age of about 5 years. Another reason for not removing the tonsils before the age of 5 years is that the other lymphoid tissue in the throat (which forms the bulk of tonsil like tissue) tries to take over the function of the palatine tonsils and hypertrophies.
3. White patches and lines on a congested (red), inflamed tonsils would be considered as an acute tonsillitis, however, if the tonsils are not inflamed and other symptoms such as fever, sore throat are missing (including a negative throat swab), then this is either chronic tonsillitis or normal. Other sources of these white discharge may be a Post Nasal Drip due to Adenoid hypertrophy (which is common at this age) or acid reflux, indigestion, allergy, sinusitis or fungal overgrowth.
4. If he has a history of snoring and mouth breathing, get an X-ray Skull, lateral view to rule out Adenoid hypertrophy and a Sinus X-ray (PNS/ Para Nasal Sinuses - Water's view).
5. Use a medicated oral rinse such as diluted Betadine or Chlohexadine.
6. Upload the Images, X-rays and clinical examination notes for further discussion.
I hope that I have answered your query. If you have any more questions I will be available to answer them.
Regards.
Could be normal if no other symptoms are present.
Detailed Answer:
Hi.
Thank you for your query.
1. If he has prominent crypts which are normally present on the surface of the tonsil, it is possible that this may just be normal food debris. Upload close-up images, if possible otherwise get his throat & neck examined in detail.
2. The tonsils scrape against the food bolus as we swallow and pick up food derbris to analyse for developing immunity. This function is important till the age of about 5 years. Another reason for not removing the tonsils before the age of 5 years is that the other lymphoid tissue in the throat (which forms the bulk of tonsil like tissue) tries to take over the function of the palatine tonsils and hypertrophies.
3. White patches and lines on a congested (red), inflamed tonsils would be considered as an acute tonsillitis, however, if the tonsils are not inflamed and other symptoms such as fever, sore throat are missing (including a negative throat swab), then this is either chronic tonsillitis or normal. Other sources of these white discharge may be a Post Nasal Drip due to Adenoid hypertrophy (which is common at this age) or acid reflux, indigestion, allergy, sinusitis or fungal overgrowth.
4. If he has a history of snoring and mouth breathing, get an X-ray Skull, lateral view to rule out Adenoid hypertrophy and a Sinus X-ray (PNS/ Para Nasal Sinuses - Water's view).
5. Use a medicated oral rinse such as diluted Betadine or Chlohexadine.
6. Upload the Images, X-rays and clinical examination notes for further discussion.
I hope that I have answered your query. If you have any more questions I will be available to answer them.
Regards.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Took him to a clinic - says viral tonsillitis (pus present) BUT strep test is also positive?!? Says we should allow him to try and fight it off with no antibiotics (which we agree with given history) BUT what are the risks if no antibiotics given? Can he cure himself from strep without these?
Brief Answer:
There are many possible complications of a Strep Throat.
Detailed Answer:
Hi,
Thank you for writing back.
1. Viral tonsillopharyngitis will not respond too antibiotics, but will not last for more than 5 to 10 days.
2. Even Strep throat would recover in most cases without antibiotics, however the risk of possible complications include rashes (Scarlet Fever), Acute Otitis Media (AOM), Sinusitis, Septicemia (Toxic Shock Syndrome) kidney damage, Rheumatic fever (involving the heart, joints, nervous system and skin), Pediatric autoimmune neuropsychiatric disorder associated with group A streptococci (PANDAS).
3. Hence he must always be under medical supervision.
I hope that I have answered your queries. If you have any further questions, I will be available to answer them.
Regards.
There are many possible complications of a Strep Throat.
Detailed Answer:
Hi,
Thank you for writing back.
1. Viral tonsillopharyngitis will not respond too antibiotics, but will not last for more than 5 to 10 days.
2. Even Strep throat would recover in most cases without antibiotics, however the risk of possible complications include rashes (Scarlet Fever), Acute Otitis Media (AOM), Sinusitis, Septicemia (Toxic Shock Syndrome) kidney damage, Rheumatic fever (involving the heart, joints, nervous system and skin), Pediatric autoimmune neuropsychiatric disorder associated with group A streptococci (PANDAS).
3. Hence he must always be under medical supervision.
I hope that I have answered your queries. If you have any further questions, I will be available to answer them.
Regards.
Note: Consult an experienced Otolaryngologist / ENT Specialist online for further follow up on ear, nose, and throat issues - Book a Call now.
Above answer was peer-reviewed by :
Dr. Shanthi.E
Answered by
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