White spots on throat--

When one sees one sees white spots in the mouth or on the throat, there
needs to be a more thorough observation as to the nature of the
"spots".  Are they crater-like lesions with a thin whitish coating, a
"pseudomembrane" such as one sees with aphthous ulcers or "canker
sores".   Aphthous ulcers in the mouth are white, because the mucous
membrane is always moist and the moist "scab" has a whitish appearance.
Strep and other organisms which cause sore throats may cause ulcerated
areas on the throat which will appear whitish.  They too will have a
"pseudomembrane" and also have an erythematous margin, or reddened area
around the whitish area.  There is usually also a foul smell to the
breath when a bacterial infection is present.

The characteristic appearance of thrush or candidiasis is a more
"creamy  coating" with the appearance of a raised plaque  that almost
looks like cream cheese has been spread on the tissue.  These plaques
appear to be something that one could scrape off, but they don't do so
readily.  If scraped off there is frequently an underlying raw, reddened
area.  Amir, Hoover and Mulford in LC Series Unit 18, describe the
infant with thrush as possibly having a "mother of pearl" appearance to
the saliva without the characteristic plaques in the mouth.

You might find it helpful to visit a medical library and look at an
atlas of physical diagnosis.  There are a number of different ones
available.  They have wonderful ??? full color pictures of all kinds of
awful medical conditions.  Becoming familar with the medical terminology
makes it possible for us to communicate more effectively and to be
perceived more professionally when we approach doctors about our
concerns.

Melinda Hoskins, MS, RN, LC2B
Director, Of a Nurturing Nature
Educational and Support Services for the Childbearing Family

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