Dear Doctor,
Following various, empirically given antibiotic treatments for prostatitis, I
developed extreme dryness in the nose and the pharynx last september. In
october I developed pharyngitis with a lot of yellowish exudate coming down
my throat. Later, I experienced constant throat pain. For about 8 months I
have had a yellowish-whitish spot on my left tonsil. It never goes away and
behind this spot, where the tonsil meets the soft palate (I guess),
ocasionally there are red sores with a tiny white center appearing shortly
after the redness (smooth surface, no fluid, size of a lentil or smaller).
These red sores heal in a week, but while I have a flare up I feel very tired
and the joint pain that I have been developing the past months ( shoulder,
hips, knees, gets better with movement) is much, much worse.
I suspect that there may be some potent organism living in the tonsil (white
spot that is not removable) that the body has a hard time fighting and while
keeping it under control I am developing some form of arthrtitis. Does this
make any sense or I should just resort to getting old and having these aches
and joint pain all the time. I am 31 and previous to the antibiotic treatments
I was very healthy. Unfortunately the prostate problem never got effectively
treated and I know that these aches and pain (Reiter's syndrome?) may be due
to that infection, but I was wondering if the tonsil plays a role here since
the pain is much worse when I have a flair-up in the mouth. I live with
constant malaise nowadays and it is very disconcerting.I would appreciate your
expert opinion.
Thank you very much.
Reply: -----------------------
The most notable aspect of your medical history that you have described is the constellation of symptomatology. When considering this constellation of symptoms, 2 unusual conditions come to mind 1) Reiter's syndrome and 2) Behcet's syndrome. Both conditions are considered to be rheumatologic disorders since arthritis is a predominant component in both. Reiter's syndrome is in general often characterized by urethritis, arthritis, conjunctivitis, superficial sores of the lining of the mouth, and a characteristic skin rash. Behcet's syndrome is in general usually characterized by a symptoms of recurring mouth sores, genital sores, inflammation of the eye, and arthritis.
You might have some chronic tonsil inflammation, but tonsillitis by itself would have little likelihood of having any relationship to the other symptoms you describe outside of the possibility of the syndromes I have mentioned.
--
Steve Dankle, MD
Otolaryngology-Head and Neck Surgery
Milwaukee, Wis
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