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911DOC
911DOC, Board Certified Dr.
Category: Medical
Satisfied Customers: 5094
Experience:  Emergency Medicine Physician
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Hi there. Yesterday morning I was diagnosed with acute tonsillitis

This answer was rated:

Hi there. Yesterday morning I was diagnosed with acute tonsillitis and prescribed amoxicillin 875mg 2x/day for 10 days. I am taking the antibiotics and ibuprofen as prescribed - but today my tonsils seem to be even more swollen and in addition to the white/yellow pus, i seem to have some spots of black. I'm afraid I might need immediate medical attention...

911DOC :

sorry to hear about this.

911DOC :

did they confirm the diagnosis with a strep test?

Customer:

yes, they performed a rapid strep test which came back negative.

911DOC :

place your cursor in the the box below where you can type and reply to me

911DOC :

standing by

Customer:

my strep test was negative.

911DOC :

okay

911DOC :

did they do a mono test? (mononucleosis)

Customer:

no. i had mono when i was a teenager.

911DOC :

that's comforting though it is possible in some cases to get it a second time (rare)

911DOC :

so you are on the right treatment for strep

911DOC :

however

911DOC :

there is a scenario in which the antibiotics will not work

911DOC :

but first let me ask

911DOC :

are you having more pain today?

911DOC :

is it difficult to swallow?

911DOC :

does it hurt to open your mouth?

911DOC :

standing by

Customer:

no, not really. the pain in my ear has mostly subsided. it's painful when I swallow, and if i open my mouth too wide, it becomes painful

911DOC :

okay

Customer:

i wouldn't say the pain is worse, though.

911DOC :

okay

Customer:

i fear it's developing into an abscess

911DOC :

so your main concern is the way your tonsils look....

911DOC :

ah

911DOC :

that's my next point

911DOC :

do you know about peritonsilar abscesses?

Customer:

the doctor at the walk-in clinic yesterday said it could potentially be a pre-abscess

Customer:

i am familiar with what abscesses are...

911DOC :

I see

911DOC :

okay

Customer:

but i don't know the specifics fortonsils

911DOC :

okay

911DOC :

so a peritonsilar abscess is caused usually by a strep infection, but the infection gets deep behind the tonsils and pus starts accumulating

911DOC :

and the throat swells

911DOC :

so the crucial things are

911DOC :

increased difficulty swallowing

911DOC :

some people if they leave it long enough start drolling

911DOC :

'drooling'

911DOC :

and it becomes painful to open the mouth (trismus)

911DOC :

usually people with these abscesses have a rapid pulse (over 100)

911DOC :

fever

911DOC :

and feel quite ill

911DOC :

so it's hard to say in your case

911DOC :

but people with these usually have rapidly progressive symptoms

911DOC :

so it seems as if you are not getting worse.... but I would prefer if you WOULD get rechecked as it is usually a visual diagnosis

911DOC :

also

Customer:

ok. how soon after starting antibiotics should i begin to see an improvement.

911DOC :

gargling with warm salt water four times a day will help clear the pus and help the healing

911DOC :

you should be getting better today

911DOC :

tomorrow at the latest

Customer:

ok

911DOC :

were you given steroids?

Customer:

if i don't see an improvement tomorrow, i'll return to the doctor.

Customer:

no, only amox.

911DOC :

okay

911DOC :

please do read the reference above as it gives very specific direction and description of PTA

Customer:

i'm not having trouble breathing, and i'm able to eat (though i don't have much of an appetite)

911DOC :

I understand

911DOC :

do you have any final questions for me

Customer:

no, i don't think so

Customer:

thank you for your help

Customer:

actually.

Customer:

1 more

911DOC :

okay

Customer:

is it normal for symptoms to worsen before they improve?

Customer:

is there a chance that the pus is greater today bc the antibiotics are focing it out?

Customer:

*forcing

911DOC :

no, not really

Customer:

ok.

911DOC :

but people are often dehydrated and they simply feel bad

Customer:

ok, i'll try to keep my fluid intake up.

Customer:

thanks for your help.

911DOC :

okay

911DOC :



Thank you so much for your question. It was a pleasure talking with you. If this answer has been helpful to you please consider leaving positive feedback. Should you require my assistance in the future simply start your question with ‘for 911doc’, and I am usually on the site most days.


Best

Customer:

thank you!

911DOC :

you bet

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