Bacteria or viruses can invade the tonsils, causing infections with symptoms like fatigue, fever, sore throat, swollen red tonsils, and the appearance of white spots or patches. These lesions may result in bad breath or a feeling of obstruction in the throat in some cases.

Tonsillitis, an inflammation of the tonsils, often stems from viral or bacterial infections. Symptoms include swollen red tonsils, a sore throat, difficulty swallowing, and fever. Some cases feature white streaks or spots on the tonsil surface due to pus. Separately, food debris, dead cells, and bacteria can become trapped in the tonsil crypts, accumulating and calcifying into opaque white particles. These are commonly known as tonsil stones and can also cause bad breath.

Tonsillitis can cause throat pain and swelling. *Photo: Dinh Tien*.

Strep throat occurs when *Streptococcus pyogenes* bacteria infect the tonsils. This illness tends to spread quickly and is more common in children, according to Health. Symptoms include a sore throat, fever, and swollen lymph nodes in the throat. The bacterial attack leads to the accumulation of dead cells, pus, and lymph, forming white patches around the tonsils. Individuals with strep throat should gargle with salt water twice daily and drink plenty of fluids to help clear the plaques and reduce bad breath.

Mononucleosis, often caused by the Epstein-Barr virus (EBV), is also known as "the kissing disease." The virus primarily spreads through saliva, such as when kissing or sharing drinks and eating utensils. The tonsils typically appear red and swollen, and may be covered with white or gray patches or secretions. Patients can also experience swollen lymph nodes, fatigue, fever, a sore throat, tiny red spots on the roof of the mouth, or a skin rash.

Oral thrush is a yeast infection that causes white patches on the tongue, inner cheeks, roof of the mouth, or throat. This condition is more likely to develop after using antibiotics or inhaled corticosteroids, or in individuals with weakened immune systems.

Sexually transmitted infections (STIs) can cause lesions in the mouth and throat, with some cases presenting white spots or patches. Human papillomavirus (HPV) and Herpes simplex virus (HSV) can spread through oral sexual contact with an infected person, leading to lesions on the lips, mouth, or throat, according to Healthline.

Treatment for white spots on the tonsils depends on the underlying cause. Patients can drink plenty of water, opt for soft foods, and avoid tobacco smoke or other irritants to alleviate discomfort. If white spots persist, recur, or are accompanied by fever, a sore throat, or difficulty swallowing, individuals should seek medical attention to determine the cause.

To reduce the risk of infections causing oral and throat lesions, everyone should wash their hands frequently and cover their mouth when coughing or sneezing. Additionally, it is essential to clean frequently touched surfaces and limit close contact with individuals suffering from contagious illnesses.

Anh Chi (Compiled)