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Sore throat, red and swollen, yellow phlegm. Due to nasal congestion or flu?

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Practicing since : 2003
Answered : 600 Questions
Dear Doctor,

I have been having a sore/itchy throat for 7 days now. I look into my throat with a torch and a mirror, I see that the back of my throat is red and possibly swelling. There are no white pus heads like a strep throat; the throat is just red and swelling. The pain was the first sign but it actually went away completely on day 3 and in the past few days it has been a bit dry and tickly. It feels a bit tight when I swallow saliva, but it does not hurt when I swallow food or liquids. I have no other symptoms: no runny nose or congestion, no chesty cough, no headache, no cough, no fever. I do feel tired during the day and have been taking naps (fortunately I have no classes for another week). I spat out a tiny bit of yellow phlegm in the mornings from Day 2 to Day 6, and today the color of phlegm is a very fainting yellow. I have been to my college doctor, who told me that it is a viral infection and is rather dismissive in answering my questions. My question is: what is going on with me, if the red/swelling throat is neither getting better or worse, accompanied by no other obvious symptoms like nasal congestion and fever? On the internet, I see that most people go through the entire full blown cold in just a week, rather than lingering on with a sore throat like me. Either that or people fight off a sore throat in a couple of days before developing into a full blow flu/cold. What are the things I can do to prevent my throat infection into a full blown cold? Is it still possible at this stage or am I just waiting for it to come? I just fought off a nasty flu in December 2011 which lasted a good 3-4 weeks. I am young and do not really get sick except for this winter. So I am quite traumatised and any suggestion from you will be appreciated!

Medicine I have taken so far: ibuprofen, 200mg caplets, 4 times per day

Many thanks!

Posted Thu, 26 Apr 2012 in Infections
Answered by Dr. Gyanshankar Mishra 10 hours later

Thanks for posting the query.

After going through your query, I would like to comment the following:

1. You seem to be suffering from acute pharyngitis with bronchitis.

2. Presence of yellow phlegm indicates a secondary bacterial infection and you need to take a course of antibiotic (like Tb. amoxicillin 500mg thrice a day) under prescription from your physician.

3. Also you need to take warm saline gargles. This will help soothe the inflammation soon.

4. Avoid cold drinks, chilled drinking water, oily foods, and use hand kerchief/mask on face during situations when you are exposed to dust. Avoid crowded places.

5. Get your blood sugar tested. Get your blood eosinophil counts done.

6. Once this episode has subsided, you may consult your physician regarding the annual flu shots.

7. Also get an ENT consultation done to rule out any possible etiological cause like tonsillitis.

I hope I have answered your query. I will be glad to answer any follow up queries.
Please accept my answer if you have no follow up queries.

Take care.


Dr. Gyanshankar Mishra
Above answer was peer-reviewed by
Follow-up: Sore throat, red and swollen, yellow phlegm. Due to nasal congestion or flu? 8 hours later
My college doctor (I'm studying in UK) insisted that I have a viral infection and would not prescribe me antibiotics. He's rather dismissive and told me to go home and rest without listening to me finishing telling him all my symptoms. He was eager to have a look at my throat and made the diagnose based on the redness and swelling. But I did tell him about the yellow phlegm. I wonder what your advice would be to get it properly treated, as it's hard to argue with a doctor? This morning I looked in the mirror, and I see that the redness and swelling are gradually going down - it's definitely better than yesterday - but still have yellowish phlegm. Many thanks, Doctor!
Answered by Dr. Gyanshankar Mishra 3 hours later

Thanks for the follow up.

After reading through your follow up, I would like to comment the following:

1. Most of the throat infections are definitely viral and they need not be treated with antibiotics unless there is evidence of superadded bacterial infection.

2. Even most of the bacterial infections of the upper respiratory tract do settle down by themselves within 2 to 3 weeks.

3. However if we need to shorten the duration of illness, we should take a course of antibiotic for the secondary bacterial infection. This is to decrease the duration of symptoms.

4. Ideally you should get your sputum tested for gram stain and culture to rule out bacterial infection of the upper respiratory tract.

5. In my opinion the yellowish phlegm definitely should be tested and ideally you should get treatment according to the results of your phlegm testing.

6. The redness in your throat is going down & this is a good sign that your infection is healing.

7. However you should stick to the advice of your doctor since he has actually examined you and you are under his follow up. You could again visit him if after the period of advised rest also you are not symptomatically relieved.

8. Also do consult him regarding annual flu shots.

I hope I have answered your query. I will be glad to answer any follow up queries.
Please accept my answer if you have no follow up queries.

Take care.


Dr. Gyanshankar Mishra
Above answer was peer-reviewed by
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