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Suggest Treatment For Recurrent Sinus Infection

Posted on Sat, 18 Apr 2015

Question: Sore throat, with large amounts of post nasal drip. lasts for 2 weeks goes away for 4 days…sore throat comes back followed by post nasal drip. This cycle has been going on for 7 weeks. During the first cycle, about 6 weeks ago, i developed a bad sinus infection and was placed on a 10 day round of Augmentin. 3 days into the treatment, has a copies amount of old blood and yellow puss discharge from my right nasal passage. Started to feel much better at day 8, sore throat started again at night, woke in the morning choking on large amounts of post nasal drip. This time sinuses did not get blocked like before. Saw doctor again at day 21. She wrote a Rx for clarythromiacin (sp?) and advised me to give it a few more days before taking the antibiotic to see if symptoms clear. Day 4 of this cycle, things got worse, with the onset of a low grade (99.2f) fever. Also started having left upper quadrant pain at the the border of my rib cage (dull pain, believe it to be related to sitting in recliner to sleep at night and laying on armrest with my left side…not positive though)…Which brings me to tonight. I am on day 8 of my Clarithromyacin regimen and sore throat, post nasal drip and ad low grade fever have started all over again. I also have a 5 year old in pre-school home with me. He has had similar symptoms (minus side pain) for nearly 8 weeks. He started with the symptoms first, I followed about 1 week after he came down with this. I have scheduled an ENT visit for Monday for both my son and I. My Primary recommended I see an ENT because of the sinus infection. I think its viral, just don't understand why I or my son are not shaking this. My wives seems to be immune…has not come down with this. I am at a loss…hoping net will shed some light on this, but am not optimistic. Any ideas? Thanks, Rich

Answered by Dr. Abubakar Siddiqh (4 hours later)

Brief Answer:
seems to be chronic sinusitis

Detailed Answer:

Hi,

I had gone through your question and understand your concerns that you are having recurrent sinus infection. I would like to ask you few more details.

Is there any sequence of sneezes followed by running nose ?

Kindly get back to me with details.

Based on clinical details, it appears to be chronic sinusitis (6 weeks) with gastritis (left quadrant pain).

I suggest you to follow this measures to overcome your sinus infection.

Recurrence could be due to allergic rhinitis, I suggest you to get CT scan of para nasal sinuses (to know the severity of sinusitis- anatomical blockage and pathological extent), blood tests (absolute eosinophilic count serum IgE) allergy. Culture and sensitivity of sinus secretions. Depending on the findings treatment can be started.

Mean time, start steam inhalation twice daily to drain the clogged sinus openings, start mucolytic tab. ambroxyl one at bed time, to drain thick sinus secretions, along with that you need to start nasal decongesents like xylometazoline 3drops/3 times.To continue ppi inhibitor tab.prilosec one tab before break fast daily to cover gastritis.

As such, viral infections causing sinusitis, self limiting, subsides with simple anti allergic medications. As you have already completed 3 courses of antibiotics, needs to know the drug sensitivity before starting the newer one.

Kindly discuss with your treating doctor, about these instructions, investigations and medications, as they are prescribed medicines need to be taken under supervision.

Hope this answers your question, if you have additional questions or follow up questions then please do not hesitate in writing to us. I will be happy to answer your questions.

Wishing you good health.

Above answer was peer-reviewed by : Dr. Pradeep Vitta

Follow up: Dr. Abubakar Siddiqh (13 hours later)

I have had a few occurrences of sneezes followed by runny nose, but it has only been (I'm guessing here) 4-6 times in the past 48 hours.

Answered by Dr. Abubakar Siddiqh (5 hours later)

Brief Answer:
Requires investigation.

Detailed Answer:

Hello again,

Thanks for considering my answer and for your follow up.

Looks like, allergy is the primary factor in causing the sinusitis.

Kindly follow the instructions and investigations as suggested earlier.

Hope, I have answered your query.

Take care.

Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Prasad