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Suggest Treatment For Chronic Sinus Infection

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Posted on Wed, 8 Jul 2015
Question: Hello,
I am 26, 6'4" and roughly 240-250 pounds, I haven't weighed myself in a few weeks. In mid-September I had an URI. I did a course of antibiotics and assuming, as I felt better, my URI cleared up. During my course of medication I began feeling tingling around my mouth. However, I assumed it was a reaction of the loratidine or valocyclovir i take almost daily and the antibiotics. the tingling essentially went away except for very rare twinges every now and then. about a week after finishing my antibiotics i began to have bloody nasal drip and discharge and a considerable amount of brown phlegm in the mornings from post-nasal drip. I babied myself and believe that what I think is probably some form of allergic rhinitis has somewhat resolved. I only have a very mild yellow nasal discharge in the morning and at times some yellow phlegm. However, during this second period of illness my facial tingling reappeared and now it extends from about parallel to my left eye down to my mouth. Likewise, my ears feel very full and are painful at times and I have spouts of vertigo and tinnitus. Also, I have been having bouts of anxiety to the point of panic attacks. This is a fairly rare symptom for me as it has occurred once in the past but has typically been under control. As my symptoms go, typically i get dizzy as I am usually walking or driving and then get nervous, at which point my face begins to "buzz" and present some mild numbness. However, the facial symptoms have also presented at times where I do not feel anxious initially, but grow anxious following their onset. The odd thing is these symptoms tend to be far worse on Sunday and slowly dissipate throughout the week, and then at a later date unexpectedly return full force again. These facial symptoms and anxiety tend to resolve at times where I am intently focused on another task or am with friends/family/in a comfortable setting but not always. Lastly, I do not believe I have lost any dexterity to my extremities as I play a guitar for approximately 1-2 hours daily and have not really seen any change in play yet.
Furthermore, please note I have a history of both HSV-1, multiple outbreaks, and Herpes Zoster, both of which have appeared on my forehead along my trigeminal nerve. Each outbreak was gradually growing worse and seemed to move farther down the nerve towards my eye and my last outbreak in XXXXXXX presented some mild eye pain and dryness. I have since been placed on valocyclovir for suppression treatment and have had no outbreaks since XXXXXXX Likewise, I have had previous diagnoses of labrynthitis and understand the symptoms associated with said diagnosis.
Unfortunately, in September, I turned 26 and lost coverage on my parents health insurance. Likewise, because my law school loans kicked in August, I have not necessarily had very much money to visit my PCP. I have in fact made an appointment for tomorrow morning. However, my question is whether this trip will be resolute in these symptoms being some relation between a lasting sinus infection, labrynthitis, with associated bells palsy/anxiety, or if it appears there is some greater cause unfortunately such as MS, a vestibular schawannoma, or possibly something worse. I have been very nervous about these symptoms and admittedly believe that I may have made them worse due to my concerns over paying for treatment. I do have health insurance that will begin, but not until January 1st. I was trying to put of seeing a physician until then but I do not think I can continue ignoring these symptoms that long. I am asking for your opinion for both a little reassurance and possibly an outlook on what to expect both prognosis-wise and financially.

Thank You for Your Time!

I apologize, however, I feel it is worth including that following my most recent HSV-1 outbreak, I had some mild neuralgia at the outbreak site and the describe eye pain/dry feeling continued.
doctor
Answered by Dr. T Shobha Deepak (3 hours later)
Brief Answer:
Symptoms are not suggestive of serious disease

Detailed Answer:
Hi
Welcome to Healthcaremagic
Greetings of the day

Dear Mr XXXX

You symptom profile more likely suggest the possibility of Chronic sinus infection leading to eustachian tube catarrh causing Otitis Media and with associated Labrynthitis. A single issue can explain all your symptoms. Based on your young age and symptoms description you are unlikely to be suffering from any serious disease like MS,schwanomma etc. Exact diagnosis will however depend on clinical examination as there is no substitute for it.
With widespread use of Internet and availability of information at click, many individuals do a lot of search fro symptoms profile attributing to all the possible disease . This leads on to more of anxiety and depression,as is also seen in your case.

I would like to reassure that there is no gross significant abnormality. Be relaxed and assured. Do consult your Physician and let me know his opinion after thorough examination

Wishing you happy and healthy life.

Take care

Best regards
Dr T Shobha Deepak
MBBS, MD
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. T Shobha Deepak (42 hours later)
I went to my physician and I was prescribed azithromycin and meclizine for a diagnosis of URI and labrynthitis. Since I have had two medical professionals tell me there does not appear to be anything significantly wrong with me my anxiety has essentially resolved. Likewise, since I have settled down I notice that the tingling seems to present itself when there is a change of level or an increase in vertigo type symptoms. Also, the tingling seems to originate from the upper region of my sinuses. I have already begun to feel better over all with the use of the antibiotic and the tingling is somewhat rare. My physician did inform me that if the tingling did not stop to contact my infectious disease specialist who has been handling my HSV-1 and herpes zoster issues as he felt it could possibly be related. Otherwise, I feel much better; at least more relaxed. My only follow-up question would be to ask your take on the idea of the tingling being related to the herpes diagnoses.

Thank You Very Much!
doctor
Answered by Dr. T Shobha Deepak (10 hours later)
Brief Answer:
Unlikely to be due to Herpes

Detailed Answer:
Hi
Dear XXXX

It's good to know that you have improvements in your symptoms.

It's less likely to be due to Herpes zoster or Herpes. The is usually severe pain associated with Herpes which is out of proportion to any visible clinical findings.
Tingling sensation with fullness is more likely to be due to Labrynthitis.

Wishing you a very happy and healthy life.

Take care

Best regards
Dr Shobha Deepak
Note: Consult an experienced Otolaryngologist / ENT Specialist online for further follow up on ear, nose, and throat issues - Book a Call now.

Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju
doctor
Answered by
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Dr. T Shobha Deepak

General & Family Physician

Practicing since :2005

Answered : 1774 Questions

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Suggest Treatment For Chronic Sinus Infection

Brief Answer: Symptoms are not suggestive of serious disease Detailed Answer: Hi Welcome to Healthcaremagic Greetings of the day Dear Mr XXXX You symptom profile more likely suggest the possibility of Chronic sinus infection leading to eustachian tube catarrh causing Otitis Media and with associated Labrynthitis. A single issue can explain all your symptoms. Based on your young age and symptoms description you are unlikely to be suffering from any serious disease like MS,schwanomma etc. Exact diagnosis will however depend on clinical examination as there is no substitute for it. With widespread use of Internet and availability of information at click, many individuals do a lot of search fro symptoms profile attributing to all the possible disease . This leads on to more of anxiety and depression,as is also seen in your case. I would like to reassure that there is no gross significant abnormality. Be relaxed and assured. Do consult your Physician and let me know his opinion after thorough examination Wishing you happy and healthy life. Take care Best regards Dr T Shobha Deepak MBBS, MD