Tonsillitis: Symptoms, Treatment, and Complications - Otolaryngology

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Tonsillitis, ulceration, foul odor?


Hello Dr.
Cheng, a couple of days ago I woke up with sudden sharp pain in my left throat.
After an examination by a clinic physician, I was diagnosed with severe swelling and redness of the tonsils, with a temperature of 38 degrees Celsius.
I have no cough, dizziness, or headache, but I am experiencing difficulty swallowing.
The doctor prescribed pain relievers and anti-inflammatory medication, along with one antibiotic pill to be taken in the morning and evening.
This morning, while eating, I noticed a strong foul odor in my mouth.
Upon self-examination, I found that the swollen area had broken skin, and when I applied pressure, a shallow brownish liquid began to ooze out.
I would like to ask Dr.
Cheng if this is likely pus? Is it problematic if I swallow it? Is there a possibility of causing bacterial infection in other areas? Thank you for your time and assistance.

Lao Zhang, 50~59 year old female. Ask Date: 2020/07/23

Dr. Zheng Jueyi reply Otolaryngology


Hello: In general, a small amount of pus swallowed will be broken down by stomach acid and typically will not cause infections in other areas.
Wishing you peace and health.
Sincerely, Dr.
Cheng Jue-Yi, Director of the Department of Otolaryngology, Taoyuan General Hospital, Ministry of Health and Welfare.

Reply Date: 2020/07/23

More Info


Tonsillitis is an inflammation of the tonsils, which are two lymph nodes located on each side of the back of your throat. It can be caused by viral or bacterial infections, and the symptoms can vary in severity. In your case, the symptoms you described—severe swelling of the tonsils, fever, difficulty swallowing, and the presence of a foul taste in your mouth—are indicative of a significant tonsillar infection, likely bacterial in nature.

The presence of a foul odor and the discharge of a brownish fluid from the tonsils suggest that you may have developed a peritonsillar abscess, which is a collection of pus that can form near the tonsils. This condition is a complication of tonsillitis and can occur when the infection spreads beyond the tonsils. The brownish fluid you mentioned is likely pus, which is a sign of infection. Swallowing this pus is generally not advisable, as it can lead to further complications, including the risk of spreading the infection to other areas of the body, such as the throat, neck, or even into the bloodstream, which could result in more severe systemic infections.

In terms of treatment, it is crucial to follow your physician's advice regarding the antibiotics and anti-inflammatory medications prescribed. Antibiotics are essential in treating bacterial infections, and it's important to complete the full course even if you start feeling better. Pain relief medications can help manage discomfort and make swallowing easier.

If you notice any worsening of symptoms, such as increased swelling, difficulty breathing, or the development of a rash, you should seek medical attention immediately. Additionally, if the foul taste persists or if you experience any new symptoms, such as fever spikes or chills, it may indicate that the infection is not responding to treatment and further evaluation may be necessary.

In summary, tonsillitis can lead to complications like peritonsillar abscess, which requires careful management. It's essential to monitor your symptoms closely and maintain communication with your healthcare provider to ensure appropriate treatment and prevent further complications. Staying hydrated and resting are also important aspects of recovery. If you have any concerns about your symptoms or treatment plan, do not hesitate to reach out to your healthcare provider for further guidance.

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