Formation behind the right tonsil

[dsionach]

I have had an ulcer-like formation (whiteish), about 0.5 in diameter, just behind the right tonsil for nearly two weeks and today two small puss pimples appeared on the right tonsil, which is a little red. I don't have any fever and only have a very mild sore throat. I went to the GP today and he said he could not see the ulcer-like thing, only that my tonsil has a slight infection. He looked a fair bit with a light, but he examined my throat with my tongue out and diagnosed tonsilitis, suggesting that I may wish to have the tonsils removed if they are repeatedly infected. I discovered after returning from seeing him that it can only be seen when the tongue is in the mouth, which causes the tonsils to lift a little, revealing the formation. I don't wish to return to the GP without giving him some kind of reason to doubt his diagnosis and appearing to be a hypochondriac. A friend whose wife died of mouth cancer agrees that it is not the worse thing and suggests it could be a lymph node that has swollen up to fight the infection. The thing is that I've seen this before over the past three or four years, starting from when I stayed in a heavily polluted city in Asia and put it down to being run-down.

Is it something serious that I should return to the GP to re-check? Can I self-medicate with OTC medicine? Is there anything you recommend?

[Vivek V Gurudutt, MD]

If you have tonsillitis, the first step would be to treat the tonsillar infection and see if the lesion improves.  In general, a persistent ulcer in the mouth should be evaluated thoroughly.  A biopsy may be needed with close follow up.  Unfortunately, the picture was not very clear I am unable to provide any diagnostic information from it.  At any time, if you are concerned, you should be able to address these issues with your physician.  Take care.  

[dsionach]

My GP said the lump was "food packing" in a small cavity behind my tonsil that became infected. The fact that this occurred before the onset of the infection of this tonsil suggests it caused the tonsil infection, which has not spread to the other tonsil - I also have no fever and very little soreness, although I feel a little more tired than usual, which to me does not suggest a virus.

Does it seem plausible that this is a bacterial infection that has spread to the tonsil from the lump?
What can I do to prevent this problem from re-occurring and at what point should I get another appointment with the GP if it doesn't clear up?
Is it true that anti-biotics are probably pointless in dealing with tonsilitis?

[dsionach]

Here's a not very good photo of my mouth:http://www.medhelp.org/photos/show/3412804?type=posts
The white thing is not clear, but it is just slightly left of the uvula just above the tongue, as it appears in the picture.