Q: My 15-year-old daughter has frequent sore throats. The doctor says she has "exudate" on her tonsils, and calls it "tonsil dandruff." Is there such a thing as tonsil dandruff? Is it normal for a teen-ager?
A: We've never heard of "tonsil dandruff." Although exudate (the presence of pus on the tonsils) is a common feature of acute sore throats.
Exudate often needs no treatment. However, its presence on a chronic basis is of some concern. It's not clear from how often your daughter gets sore throats or whether the exudate persists despite antibiotic treatment. Teen-agers who get three or more sore throats (associated with tender swollen glands) per year over several years may be candidates for tonsillectomy.
There are other causes of chronic sore throats that should be explored:
* Does your daughter smoke cigarettes or are there other smokers in the house?
* The excessively dry air in many homes during the winter can dry, and therefore irritate, the mucous membranes in the nose and throat. A humidifier in your daughter's room may help if this is the case.
* Sinus problems, which can be allergic, bacterial, or viral in nature, can lead to post-nasal drip and a sore throat.
*Treatment of the underlying cause should help alleviate recurrent sore throats.
Dr. Wilson is director of pediatric primary care of the Johns
Hopkins Children's Center; Dr. Joffe is director of adolescent medicine.