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Persistent sore throat, recurent folliculitis - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Very Good Posted in: Ear, Nose and Throat Problems
Answered by

General & Family Physician
Practicing since : 2005
Answered : 2408 Questions
User :   Hi,
I am and as a foreigner it's not easy to communicate, so I would like to ask your opinion first.
About 1 year ago I had a severe sore throat, with vomiting, fever and also vertigo. My throat was very white with puss. The doctor gave me some first line antibiotics I think, and after a few days it subsided.
However over the past year, I will get a twinge of sore throat again when I am tired or run down.
Now it's started getting more painful again. I checked my throat and have an approximately 0.75cm white spot on my right tonsil, left one seems clear now. It isn't currently as severe as one year ago. I have also recently in the last 2-3 weeks had an eye stye, mouth ulcer and a spot on my upper lip.
Also have a mild cough and sneezing. Don't appear to have a temperature yet.
What's your opinion. Are the stye, ulcer and spot related to the throat? Could it be a strep infection that has lingered for over a year? Thanks
Doctor :   hi
Doctor :   Dr AAAAAAA here
User :   hi Dr AAAAAAA
Doctor :   let me read what you have typed
Doctor :   Strep infection lingering for a year dormantly and again getting re-active, could be on ereason
Doctor :   in such case the the mouth ulcer could be related to teh infcetion and teh tonsil lesion
User :   right, would that ocassionally cause a twinge in your throat but not serious infection?
Doctor :   but the stye might not be related
User :   ok, would a skin strep infection cause styes and spots?
Doctor :   it can cause you occasional symptoms, which if not severe will go away with gargling or having lot of warm fluids
Doctor :   yes, it can cause, due to transfer of infection by hands
User :   that makes sense, i never really felt like it cleared up and they didn't do a throat swab, just a nasal one because they were panicking over bird flu
Doctor :   do you have any other associated symptoms?
Doctor :   ok. then a throat swab and culture is necessary to identify the infective agent to be able to treat it effectively
User :   right now, as described, bit sniffy, mild cough. Not as bad as 1 year ago
User :   i live in a humid climate and often get folicle infection as well, so thats why I was thinking strep
Doctor :   ok. thwn at this this, a warm salt water gargling about 2-4 times a day and warm fluids will help in giving you mild relief
Doctor :   *then
Doctor :   ok. if you do get recurrent infection, i would recommend you to have your sugar values checked.
User :   ok..
Doctor :   pre-diabetes or occult diabetes can also be a cuase of repeated infection
Doctor :   and also persistent infection
User :   right ok
Doctor :   so get an FBS, PPBS and BbA1C test done
User :   if it is strep throat, would the same antibiotic help with any strep skin infection
Doctor :   HbA1C test is also known as glycosyklated hemoglobin
Doctor :   it can detect you sugar control over last 2-3 months time
User :   right ok, hopefully they do that here!
Doctor :   it should help , but we cannot be sure, if the strains are different, then it might not work
Doctor :   and you might need a broad spectrum antibiotic
User :   ok, would a first line antibiotic be ok or would i need something stronger? The medicines generally used in Japan tend to be weaker
User :   i think last time it was amoxicillin or osmething similar
Doctor :   as I said, it is better to have a swab test sand culture done from the mouth ulcer and the lesion from tonsil along with a throat swab to see if the infection is caused by bacteria or fungi (white appearance could also be related to fungal infection)
Doctor :   this would decide which antibiotic is best suited to eradicate the infection
User :   ok right, i will insist on that in my bad Japanese this time, and not let them just give me antibiotics at random
Doctor :   along with the culture sensitivity check get the sugars also checked
User :   ok was that BbA1C or HbA1C you typed both?
Doctor :   so that appropriate line of treatment can be followed
Doctor :   HbA1C, I am sorry about the typo error
User :   ok so these: FBS, PPBS and HbA1C are for sugars PLUS swabs for infection
Doctor :   yes, exactly.
User :   ok thats great, Im sure they must be pretty international terms. I'll go and get those done
Doctor :   yes, they are international terms, on safer side you can say "culture and sensitivity" tests for the swab tests
Doctor :   have you followed what I have said?
User :   ok
User :   yes thats very helpful. If i was in the US I wouldn't need to do this, but here it's better to be prepared before you go to the doctor!
Doctor :   FBS=fasting blood sugar, PPBS= postprandial blood sugar, HbA1C=Glycosylated hemoglobin
User :   great thanks. just in case they dont recognise the letters!
Doctor :   swab tests= culture and sensitivity tests
User :   ok
Doctor :   is there anything else you would like to ask me?
User :   no thats fine I think, thank you for your time
Doctor :   ok. thanks for consulting me. bye for now. do get back to me if you have further queries
User :   ok thanks
Doctor :   wish you good health.
User :   thanks bye
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