Family, Internal Medicine, General Medical Questions/Abscess on tonsil

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Throat
Throat  
Hi,

I went to my doctor's office this week and was told I have an abscess on one of my tonsils. Is this different than strep? They did take a culture of my throat, but I do not know the results yet. I was given an antibiotic over the weekend at urgent care for my sore throat but they did not perform any test or culture because a week earlier I had been exposed to strep. My doctor's office gave me a stronger anitbiotic and prednisone because my throat felt worse and my ear looked red (and hurt). I was told if the abscess did not go away then they would send me to an ENT for treatment. I have not had a fever and other than my throat being sore and my ear hurting I feel fine. My throat is not very swollen or red. It has looked worse with a sinus infection, but of course with no white spots. How long should it take for me to know if the antibiotic is working to help the abscess go away? I have attached a picture of my throat from today so you can see. The antibiotic was switched from a Z-PAC to Levofloxacin.

Thanks

Answer
If you finished the zpak, then that should cover strep.   Levo is not a great strep drug, but covers the general sinus infection bugs fairly well.   The picture is difficult to interpret, but it looks like some L tonsil swelling with the white spot on it.   This could be a tonsillar abscess or could simply be an infection with swelling.   If it improves in 3 days, great, if not, it may be worthwhile going to an ENT.

Cultures are tricky.... if someone is exposed to strep, I tend to assume it is and treat.... the culture takes a few days and I can have someone better by then.    Basically, 3 days and then re-evaluate if not improving.   

PS... there are other viral illnesses that can cause this picture that tend to go away on their own.   If you develop trouble swallowing/breathing, you need an immediate re-eval.

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Robert Borucki

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