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What Commonly Causes Sore Throat with White Spots?

By Erin J. Hill
Updated Feb 29, 2024
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Strep throat is one of the most common causes of sore throat with white spots. It is caused by a bacterial infection, and can result in white pus nodules as well as a white or yellow film in the mouth and on the tongue. Sometimes bacteria can also accumulate on or in the crevices of the tonsils and cause small white spots as well. This may or may not be accompanied by a sore throat.

Sore throat with white spots are two of the hallmark symptoms of strep throat. The streptococcal bacteria is responsible for these symptoms, and can also cause a high fever, bright red throat and mouth color, and swollen tonsils or lymph nodes. If sore throat is accompanied by coughing, sneezing, or runny nose it is probably not strep, but a viral infection.

The sore throat with white spots associated with strep throat are associated with inflammation due to bacteria and pus pockets which can form anywhere in the mouth or throat. There are various strains of strep bacteria, and some are more violent than others. Doctors usually prescribe antibiotics to help the infection heal faster, but this is not always effective. Medicated throat sprays and over the counter pain relievers are commonly used to alleviate soreness.

White spots and soreness both disappear when the infection is cleared. There are generally no long-term effects of strep throat. Young children get the illness more often than adults, mostly because they are in school around other children and may share utensils, forget to wash their hands, or put objects in their mouths if they are very young. A high fever may occur and should be brought down using a fever reducer. If it does not break within several hours of using acetaminophen or another fever reducing medication, the child should be seen by a doctor.

Another cause of sore throat with white spots is bacterial accumulation on the tonsils. Sometimes this occurs when food particles become stuck in the crevices after eating and creates a breeding ground for bacteria and germs. This can lead to inflammation and pain. Other times a viral or bacterial infection irritates the tonsils and forms pus pockets, causes swelling, and leads to pain. Antibiotics such as penicillin are often prescribed for tonsillitis and other infections of the tonsils. Occasionally, if infections are chronic, the tonsils are removed.

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Discussion Comments

By LesterT — On Apr 12, 2011

@MikeVann - Yep. I’m pretty sure this is a pretty common problem in terms of any kind of illness. A lot of times we don’t want to question our doctors, but especially when the symptoms are severe we should make sure we get what we need. I’ve had strep throat a couple times before. It was usually strep throat with white spots, but the couple times it hasn’t been I’ve had to push to make sure my doctor knew the severity.

It’s always been hard to do, but making my symptoms and needs clear has always been really helpful in making sure my doctor can really help me.

By MikeVann — On Apr 12, 2011

I had to learn the hard way that strep throat doesn’t always include white spots. A year ago I had the worst sore throat of my life along with a high fever. I went to the doctor for it, but since I didn’t have the white spots he assumed it was just a normal sore throat. Only when the fever got a lot worse did he do a strep test. He found out I had strep, not just sore, throat, but only after I was in really bad pain for longer than necessary.

I’m sure it was just that particular doctor, and I’ve since changed doctors, but has anyone else dealt with this kind of predicament?

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