Throat infection, when I saw I can clearly see so many small white whi

Throat infection, when I saw I can clearly see so many small white white thing starting from after hard palate, on right and left side of the neck. Difficulty swallowing, taking antibiotics (cephalosporin), pain killer, cetrizine, dsr from 2 days no improvement

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white patches tonsils both sides difficulty swallowing not improving after antibiotics when to see doctor

Based on what you're describing, bilateral white patches on the tonsils (just behind/below the hard palate = the tonsillar area), pain on swallowing, and swelling on both sides of the neck, this is classic exudative tonsillitis - inflamed tonsils with pus/exudate, plus reactive cervical lymphadenopathy (swollen lymph nodes) from the infection. This pattern is described in most ENT and infectious disease texts as typical of either:

1. Bacterial tonsillitis (Group A Streptococcus)

Tonsillar exudate, fever, tender bilateral neck nodes, no cough are the classic "Centor criteria" - Schwartz's Principles of Surgery, p. 2731; Scott-Brown's Otorhinolaryngology

2. Infectious mononucleosis (EBV)

Also causes prominent bilateral exudative tonsillitis with heavy white exudate and marked, sometimes massive, cervical lymphadenopathy - often more exudate than strep, plus fatigue/malaise - Scott-Brown's Otorhinolaryngology Head & Neck Surgery, p. 7953-7977; Cummings Otolaryngology. Mono is important to consider precisely because it does not respond to antibiotics - this could explain "no improvement after 2 days."

Why 2 days may not be enough - and when it's a real concern

Antibiotics for tonsillitis typically need 48-72 hours minimum before you'd expect visible improvement, so 2 days alone isn't automatically a treatment failure.
However, if it's mono, no antibiotic will help, and you need reassessment rather than a stronger antibiotic.
A 2023 systematic review on recurrent/treatment-resistant acute tonsillitis (PMID 37881239) and a 2025 review (PMID 40168968) both emphasize that persistent or worsening symptoms despite adequate antibiotics warrant re-examination and consideration of alternative diagnoses (mono, resistant organism, or evolving abscess) rather than just extending the same regimen blindly.

Red flags that need urgent in-person evaluation (ER/ENT), not just a phone consult

Go get examined urgently if you have any of:

Pain becoming one-sided and worse, especially with a muffled ("hot potato") voice or uvula pushed to one side - suggests a peritonsillar abscess, which needs drainage and won't resolve on oral antibiotics alone
Trismus (can't open your mouth fully)
Drooling or inability to swallow your own saliva/fluids
Difficulty breathing, stridor, or feeling your throat is closing
High fever that isn't settling, or you're becoming dehydrated from not being able to drink
Neck swelling that is hard, rapidly enlarging, or very tender on one side out of proportion to the other

None of these are guaranteed from what you've described, but bilateral tonsillar exudate + bilateral neck swelling + dysphagia not improving on antibiotics is exactly the picture that should be re-examined by a doctor in person now, rather than continuing the same medicines and waiting further. They will likely want to:

Look directly at your throat and feel the neck nodes
Consider a throat swab / rapid strep test
Consider a monospot/EBV test if nodes are prominent or you're very fatigued
Decide if the antibiotic needs changing (e.g., to amoxicillin-clavulanate if bacterial and not responding) or stopping (if mono)

What you can do while awaiting reassessment

Keep well hydrated - dysphagia raises real risk of dehydration, this matters more than the antibiotic itself in the short term
Warm saline gargles, soft/cold foods, throat lozenges for symptomatic relief
Continue the pain reliever as prescribed for comfort, but don't add or increase doses on your own
Do not just switch antibiotics yourself - if the current one isn't working, that decision needs an exam, not self-substitution

I don't have your exam findings (uvula position, trismus, fever curve, node character), so I can't tell you definitively whether this is simple bacterial tonsillitis, mono, or an early abscess from a text description alone - that distinction needs a doctor to look at your throat and neck directly, ideally today given the lack of improvement.

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And having ulcers on tongue as well from last 1 day

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tonsillitis with white spots plus tongue ulcers viral cause herpangina hand foot mouth adult

The new tongue ulcers (appearing within the last day, on top of the tonsillar white patches, throat pain, and swollen neck nodes) shift the picture more toward a viral cause, which explains why 2 days of cephalosporin hasn't helped at all.

What I can see in your photos

The images mainly show the front/underside of the tongue being held down with a spoon/depressor - the tip and margins of the tongue look reddened and mildly inflamed, with what may be a small pale/white ulcerated patch near the tip in a couple of frames. I can't get a clear view of the tonsils or the back of the throat in these particular shots (the depressor and angle block that area), so I can't confirm whether the tonsillar white spots and the tongue ulcers are the same process just from these.

Most likely explanations now

Combining bilateral tonsillar exudate + bilateral neck node swelling + painful swallowing + new tongue ulcers + no response to antibiotics, the textbook differentials point toward a viral illness rather than plain strep:

Herpangina (coxsackievirus): causes small (1-2 mm) grey-white ulcers specifically at the back of the mouth - soft palate, tonsillar pillars, near the tonsils - which can match "many small white things" you described near the hard palate junction. Usually resolves in ~10 days on its own; antibiotics do nothing for it - Goldman-Cecil Medicine.
Primary herpetic gingivostomatitis (HSV-1): causes painful ulcers spread across the tongue, gums, and oral mucosa along with a sore throat and tender neck nodes - fits a new crop of tongue ulcers appearing a day or two into a throat illness.
Hand-foot-mouth disease (coxsackievirus, can occur in adults too): mouth ulcers plus tonsillar involvement; look for any spots/blisters on palms, soles, or fingers.
Infectious mononucleosis (EBV): heavy bilateral tonsillar exudate with marked cervical lymphadenopathy is classic; oral ulcers/aphthae can occur secondarily during the immune stress of the illness.

Standard emergency medicine teaching is explicit on this point: when oral ulcers/vesicles are present alongside pharyngitis, this is considered a clinical sign of a viral cause, and testing/treating for strep is not recommended in that setting - Tintinalli's Emergency Medicine, p. 1155; Rosen's Emergency Medicine.

One important safety flag

You are still on a cephalosporin. New mucosal ulcers appearing while on an antibiotic, while usually just the viral illness running its course, can very rarely be an early sign of a drug hypersensitivity reaction (e.g., erythema multiforme/Stevens-Johnson spectrum). Watch closely for:

Any skin rash, target-shaped spots, or blistering
Red or gritty eyes
Lips becoming swollen, cracked, or crusted
Skin peeling anywhere

If any of these appear, stop the antibiotic and get seen immediately (this is an emergency, not a wait-and-watch situation).

What to do now

Given the combination - not improving after 2 days, new oral ulcers, bilateral neck swelling, and painful swallowing - this needs an in-person re-look by a doctor (physician or ENT), not just continuing the same medicines:

They can directly inspect the posterior pharynx/tonsils (which your photos don't capture), check for asymmetry, feel the neck nodes, and look for the pattern of ulcers to tell herpangina/HSV/HFMD/mono apart
A monospot/EBV test or clinical exam may be warranted if nodes are prominent
If it's viral, the antibiotic may be safely stopped and care shifts to purely supportive treatment

Supportive care in the meantime:

Keep sipping fluids often, even small amounts, to prevent dehydration since both throat pain and tongue ulcers make eating/drinking hard
Cool, soft, non-acidic, non-spicy foods (avoid citrus, tomato, salty/spicy items which sting ulcers)
Warm saline gargles for the throat
A topical oral gel/rinse for the ulcers can help with pain (ask the pharmacist/doctor for one appropriate for you)
Continue the pain reliever as already prescribed for comfort

I'd treat this as "go get examined today" rather than waiting further, mainly because of the combination of non-response to antibiotics plus a new symptom (oral ulcers) that changes the likely diagnosis.

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