Sore dry throat, Patchy tongue... confused?

[Davidb90]

Ok so this is quite a complicated problem but would appreciate if you bear with me!

I am 21 year old man about 2 months ago started getting cold like symptoms aching muscles tiredness etc. and two days later swollen red and painful tonsillitis. I went to dr. Next day who prescribed penicillin v for 7 days. The pain went after approximately 4-5 days but whilst the swelling went down it didn't ever go completely down. A week after completing antibiotic I got ulcer like sores around my lips and on my cheeks in a straight line which were not particularly painful (certainly less painful than normal mouth ulcers). Went to dr. again who suggested it might be a fungal infection due to antibiotic and gave me topical antifungal. The sores were gone within a week and didn't cause many problems. I continued to feel tired etc and only started to feel better after another two weeks or so.

Just as I was starting to feel better the muscle aches and tonsillitis came back and I felt shivery (all symptoms came at once, but only tonsillitis lasted more than a day) tonsils were bigger and redder than before and extremely painful. My right tonsil also had a White coating further back and is quite deformed. Went to out of hours dr following day who gave me 10 days penicillin V and told me to get blood test for glandular fever which I did and was negative, my full blood count showed only a slightly high eosinophil count (i have eczema which may explain this) However  I started getting small blisterlike sores on soft palate and tonsils which were difficult to see but can be felt with tongue and are patchy red and feel like burning and make it difficult to swallow. I also had an ulcer on my right tonsil which looked exactly like a normal mouth ulcer. I also got the same 'sores' as before inside lips, cheeks and had a painful tongue.  All my symptoms are now gone other than my tongue which is patchy and feels as though it is burnt, the patchy areas seem as though they are bald and it is mainly the centre of the tongue that looks like this.  My throat and soft palate is still red and tonsils look swollen (definitely not as much as before and they arent painful) but throat feels dry and almost scratchy.  There are no visible sores inside my lips but when i drink orange juice or eat spicy foods they hurt (sort of stingy pain).  I thought it could be an allergy eg hayfever but ive been taking cetirizine daily for about a week which has had little effect. I was also worried about it being herpes but I have never had a cold sore in my life.  My tongue symptoms could be geographic tongue but would this cause other mouth symptoms? and is it just coincidence it happened at time of tonsillitis.

Im really at a loss as to what it could be?

Any ideas? My dr. doesnt seem to be concerned but its bothering me! He says tonsils can remain swollen in people who have had recurrent tonsillitis but doesnt explain the rest of my mouth symptoms

Thanks alot, would b great to hear ideas!

[Davidb90]

I did wonder if it was a vitamin deficiency as I know they can present with symptoms in the mouth. Its good to hear that you think this sounds normal after tonsilitis and I will definitely try and take your advice! Im a student and have just graduated so maybe the drinking hasn't been helping and I'll try and limit that at the moment. I definitely don't eat enough fruit and veg either so will try this!

Thanks v much I'll let you know how I get on with this!

[OHNS2010]

Hi David,

The description of your problems is excellent. Well, now you have almost got rid of the tonsil infection, but still there is residual congestion of the tonsillar pillars and enlarged tonsils. This is the common picture seen in chronic tonsillitis.

Regarding the burning sensation in the oral cavity is because of the antibiotics you have taken and also the cetrizine you are on. Cetrizine causes dryness of the mucosa leading to irritation in the throat, nose and the mouth. So, stop cetrizine for some time, I would rather encourage you to drink plenty of warm water, consume plenty of fresh fruits and vegetables and take some vitamin B- complex tablets. This will help in regeneration of the damaged mucosa. Avoid stress, coffee, tea, alcohol, smoking and chilled foods.

Geographic tongue is because of the atrophy of the filiform papillae of the tongue, surrounded by a serpiginous, white, hyperkeratotic border. Patients with geographic tongue may present with a burning sensation or an irritation of the tongue noted with hot or spicy foods. No medical intervention is required because the lesion is benign and most often asymptomatic.

Any more doubts you are welcome.

Regards
OHNS2010