When someone has a sore throat, one of the first things they may do is check the back of their mouth.
The tonsils, which are part of the lymphatic system, are located on the back of the throat. If white spots are present on the tonsils, it is understandable to be concerned.
The good news is that several conditions can cause white spots on the tonsils. Most of them are easily treated. When white spots appear on the tonsils, they may present as blotches or streaks. They may also contain pus.
The most common symptom that occurs is a sore throat. White spots on the tonsils usually indicate an infection. Treatment varies depending on the cause.
The most common cause is an infection. Infections may be due to bacteria, a fungus, or a virus.
Although anyone can develop an infection that leads to white spots on the tonsils, having a weakened immune system puts a person at a higher risk.
Some of the more common infections that can cause white spots include:
Strep throat is a bacterial infection caused by Streptococcus.
Complications of strep throat can develop if the bacterium causing the infection spreads to other parts of the body, such as the heart. Complications include rheumatic fever and ear, and sinus infections.
Additional symptoms that may indicate strep throat include:
- sore throat (Dealing with painful sore throat)
- swollen glands in the neck
Strep throat is a common infection, especially in children. According to the Centers for Disease Control and Prevention (CDC), up to 6 out of every 20 children with a sore throat have strep throat.
Oral thrush is a fungal infection in the mouth. Oral thrush can develop in anyone but is most common in babies. It can also occur as a side effect of medications, such as oral steroids.
People with a weakened immune system are at an increased risk of a fungal infection, including oral thrush.
White spots may be the only symptom of oral thrush, but when additional symptoms develop they may include:
- pain when swallowing
- loss of taste
- White spots may also appear on the cheeks, tongue, and roof of the mouth.
- Viral tonsillitis
Tonsillitis involves inflammation or swelling of the tonsils. Although the Streptococcus bacterium can lead to tonsillitis, it is not the only cause.
Tonsillitis can also develop due to a viral infection. Symptoms may include:
- swollen tonsils
- painful swallowing
- ear pain
- nasal congestion
Common viruses that may cause tonsillitis include rhinovirus, adenovirus, and respiratory syncytial virus.
Mononucleosis is a viral infection caused by the Epstein-Barr virus, which affects certain blood cells.
Along with white spots on the back of the throat, symptoms may include:
- sore throat
- Infectious mononucleosis spreads easily from person to person.
- Tonsil stones
The tonsils have several crevices. Bacteria and mucus can become stuck in them. When this material gets trapped, the debris may harden and calcify, which causes white spots.
Symptoms may include:
- bad breath
- ear pain
- painful swallowing
Some people may not even notice they have tonsil stones, especially if the stones are small.
A medical exam will aid diagnosis and may include looking in the back of the throat and feeling the lymph glands in the neck.
In some cases, doctors may recommend blood tests and a throat culture. Blood tests indicate if certain antibodies are present, which helps identify specific infections.
A throat culture involves rubbing a cotton swab across the back of the throat to collect a sample from the tonsils.
The cells and secretions collected are analyzed to identify the presence of bacteria and determine the type of infection.
There are a variety of causes of white spots, so there is a range of treatments. For example, if spots are due to tonsil stones, treatment may include removal of the stones.
Spots due to strep throat require an antibiotic. White spots on the tonsils due to an oral yeast infection may need antifungal medication. If recurrent infections of the tonsils are an issue, surgery may be recommended to remove the tonsils.