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Sore throat, taken Doxycycline. Sore ears, lump at base of throat. Not strep. What is going on?

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Hi, had a cold 8 weeks ago, after which a sore throat would come and go. Doctors gave me doxycycline, throat better for few days then sore again. Back do doctors, got amoxycilan and chest xray showed chest infection, so after another week got more doxycycline to clear infection as spit sample showed what infection it was. Anyway, throat still sore every couple of days. Doctor then confirmed chest sounded clear, but took various bloods, glandular fever, hiv, thyroid etc etc and all came back ok. So they say that even after 8 weeks it must be bad viral infection. Throat is sore for a couple of days at a time now, sore ears at times too, feels like a lump at front/base of throat, aware of it when tilting head back forth, swallowing etc. Area of pain has changed now and again. Doctors everytime said throat looks fine, no sign of strep, no chance of tumors etc with bloods done. Also said chest xray was great other than infection showing in lung. Getting worried though as everywhere online says long term throat problems are bad news. I feel generally not too bad otherwise, bit tired yet and sore at times, but its just my throat and ears! Little itchy but no rash around neck, doctors discount this. Sick occasionally with it, have been a bit anxious, 3 different doctors in total, do smoke, otherwise healthy, no known allergies, no history of reflux (take indigestion tablets once a month or so) been fit enough (until cold came cycling 80-100 miles most weeks until caugh came after my cold). Doctors last visit says all is ok, everything checks out ok, just wait and see. 2 months on I'm getting anxious again, can viral things last this long and come and go so much? Thanks in advance for any input!
Posted Mon, 24 Sep 2012 in Ear, Nose and Throat Problems
 
 
Answered by Dr. Naveen Kumar 2 hours later
Hi

Thanks for the query and a detailed history.

I feel the root cause of all your problems is smoking. Smoking causes damage to mucosa of the throat making it susceptible to attract infections. Also, constant damage to the mucosa of the throat causes enlargement of the lymphoid follicles in the throat causing grating sensation while swallowing and turning the neck.

Secondly any acid reflux from the stomach into the esophagus and throat can present with similar complaints which will not respond with antibiotics. Acid when it regurgitates from the stomach into the throat, causes burning of the mucosa of the throat leading to inflammation of the throat. Inflammation of the mucosa in turn induces swelling in the mucosa of the throat giving rise to foreign body sensation.

The causes of reflux of acid are many, medicines, obesity, stress, food habits, smoking, alcohol, etc. Identifying the causative factors and avoiding them can give you relief from this problem.

My advice to you is:
1. Reduce or better to abstain from smoking.
2. Drink plenty of warm water, this keeps the mucosa hydrated as well as improves the blood circulation in the throat thus reducing the discomfort and the chances of infection.
3. Avoid chilled food/beverages, coffee and alcohol.
4. Use povidone iodine throat spray 3-4 times a day after food.
5. Suitable antibiotic such as a combination of amoxycillin and clavulanic acid or cefuroxime.
6. A proton pump inhibitor such as omeprazole or pantoperazole for controlling silent acid reflux.

With all of the above measures you will definitely be alright.

Hope I have answered your query; I will be available for the follow-up queries.

Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon
Above answer was peer-reviewed by
 
Follow-up: Sore throat, taken Doxycycline. Sore ears, lump at base of throat. Not strep. What is going on? 14 hours later
Hello again, thank you for your detailed answer.

I will certainly try all of the suggestions, though its seems some of the things are only available prescription here in Uk, but will try anything. When throat is sore ears are too, and I can feel every movement I make with my neck.

The doctors said I must have had viral infection too, and symptoms similar to glandular fever, although that blood test should negative. I've felt so weak in the body at times that I think I've strained myself causing pain at times and therefore concern. For example i was sick yesterday and imediatly think thats why my left armpit upper chest area is a little sore.

My question is the doctors said my chest sounded okay last week, yet I still have a little cough bringing up mainly bubbly stuff but occassionally a bit of yellow greenish stuff.

After my cold subsided and I was back out exercising on the bike, after 10-15 miles my cough would start (which is what lead me to doctors in first instance along with sore throat then finding out chest infection).

I'm keen to try and get back to normal, think biking is one way of doing that, and to help stop smoking by getting back out and getting active again.

With the cough and bringing a little stuff up, and the throat irritation, do you think its wise to try?

Thank you for your help, obviously heart problems, throat tumors, cancer etc have all gone through my mind!
Follow-up: Sore throat, taken Doxycycline. Sore ears, lump at base of throat. Not strep. What is going on? 4 hours later
Hi again, hopefully not a totally stuipid question, just peace of mind. My body has been hurting in different places at different times, last doctor though I'd hurt my back possibly causing pain all over at times, it does change. Today is was my left armpit, upper chest area to the left, its now round to what feels like my back a little. Since you mentioned warm drinks, been drinking hot blackcurrent diluting juice. What I'm coughing up today firstly had a few little bits in it and i though maybe the warm juice was helping to clear stuff out, now its got little redish bits- am I stupid in thinking its anything other than the blackcurrent juice!!!?
 
 
Answered by Dr. Naveen Kumar 29 minutes later
Hi

Thanks for writing back

Q: When throat is sore ears are too, and I can feel every movement I make with my neck.
A: This is because the throat and the ear share the same innervations; hence any pain in the throat it will be felt in the ear too. And, it is absolutely not related to the ear.

Q: i was sick yesterday and imediatly think thats why my left armpit upper chest area is a little sore.
A: Recurrent viral infection can cause generalized malaise hence the perception of the body pain. This is also normal, and part of the infective process. Pain relievers such as diclofenac or ibuprofen will give you relief from this.

Q: My question is the doctors said my chest sounded okay last week, yet I still have a little cough bringing up mainly bubbly stuff but occassionally a bit of yellow greenish stuff.
A: The greenish stuff is indicative of severe infection and it is not viral, but bacterial. You will require a good antibiotic such as a combination of amoxycillin and clavulanic acid or cefuroxime or a couple of weeks to treat this infection.

The cough with expectoration is due to the post nasal drip from the sinuses. As the discharge from the nose trickles down into the throat from the nose, it irritates the throat thus causing all the above problems. This is also confirmed by doctors who mention that the chest is clear.

Q: After my cold subsided and I was back out exercising on the bike, after 10-15 miles my cough would start
A: When you do cycling the blood supply in the nose increases, because of which there is excessive production and clearance of the mucus. This excessive clearance from the nose induce cough and I really doubt it is from the chest.

Q: With the cough and bringing a little stuff up, and the throat irritation, do you think its wise to try?
A: Absolutely no smoking at this stage, if you do so, you will have to take the brunt of it and thus it will complicate the present situation and makes it worse.

Q: obviously heart problems, throat tumors, cancer etc have all gone through my mind!
A: I can assure you, it is not related to any of these XXXXXXX conditions. Please, take it out of your mind.

Q: Hi again, hopefully not a totally stuipid question, just peace of mind. My body has been hurting in different places at different times.
A: Please do not feel sorry for asking questions, you have paid for it and it is my responsibility to make you feel comfortable and answer all your queries promptly. Your body pain in different places at different times is because of the unresolved infection. Once the infection clears off completely, you will feel better.

Q: am I stupid in thinking its anything other than the blackcurrent juice!!!?
A: I do feel, either it could be the blood clots following cough, which is due to rupture of the minute blood vessels or coating of the secretions with the black current juice. This is not a major issue; avoid taking anything sour at this time.

To sum it up:
1. Continue drinking plenty of warm water.
2. Take appropriate antibiotic and pain killers.
3. Use saline nasal spray to keep the nasal mucosa moist and easy clearance of the secretions in the nose and the throat, followed by steam inhalation 3-4 times a day.
4. Avoid smoking as much as possible.
5. A mucolyte such as ambroxol or bromhexine will help in clearing of the secretions from the throat.

I wish you good health.

Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon
Above answer was peer-reviewed by
 
Follow-up: Sore throat, taken Doxycycline. Sore ears, lump at base of throat. Not strep. What is going on? 2 days later
Hi again, I thank you for your detailed answer, and have recommended this site to family, since I am impressed at the level of detail given to my questions.

Been taking hot drinks, bought nicotene patches today planning on stopping smoking completely this week.

When my throat/neck/ears are sore, I am still feeling a bit itchy, though no obvious signs to me. Is this cause for concern? Pain feels as if up to glands at times but not sure.

The fact its gone on for so long now I'm just praying it'll go soon! I must admit I got worried today again about tumors, throat cancers etc!

I'm keen to feel good again and get back out cycling, also knowing its the best "stop smoking" option for me as it keeps my occupied and feeling great at the same time. I know you can't examine me, but from what I've said do you think it'd be okay for me to start exercising again?

Thank you again for all your advice/help.
XXXXXXX
 
 
Answered by Dr. Naveen Kumar 1 hour later

Hi

Thanks for writing back

I am happy to learn that you are satisfied with this discussion, we will be glad to help you out with any of your health related problems in future.

I wish you good luck in your attempt to quit smoking.

Q: When my throat/neck/ears are sore, I am still feeling a bit itchy, though no obvious signs to me. Is this cause for concern? Pain feels as if up to glands at times but not sure.
A: This usually happens due to unresolved or residual inflammation in the throat. Do not worry! A short course of oral steroids will help in reducing this problem.

Q: I must admit I got worried today again about tumors, throat cancers etc!
A: It is very unusual to have throat cancer at this age. I can assure you with the symptoms you have described it is less likely to be symptoms of any malignancy. If you are still not convinced, get a MRI of the neck done, this will give you peace of mind.

Q: but from what I've said do you think it'd be okay for me to start exercising again?
A: You can definitely restart your exercise; it will keep you occupied as well as help you in quitting smoking.

Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon
Above answer was peer-reviewed by
 
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