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Suggest Treatment For Severe Sinus Infection, Occasional Nasal Bleeding And Congestion
Question: About 3 weeks ago while taking coumadin I developed a bad sinus infection. My phlegm was thick and green and then started to get bloody as well. The blood in my phlegm comes and goes. I have been off coumadin for over a week, but I still have nasal congestion and have to clear my throat of phlegm several times a day, and there may be blood with the phlegm. I am not coughing; the blood only occurs when I clear my throat. I have taken azithromycin. I do not smoke. I do not have a sore throat,nor hoarse, but I do have a post-nasal drip and allergies. What do you think I should do.
Brief Answer:
Coagulogram, Sputum examination and C/S, Sinus CT, Medications.
Detailed Answer:
Hi.
Thank you for your query.
1. In about a week the effect of coumadin should not make a difference.
2. You can get a coagulogram to confirm. You can also get a sputum (phlegm) sample tested for occult blood. A bacterial + fungal culture & antibiotic sensitivity (C/S) test is also recommended.
3. If the coagulaogram is within normal limits, the nose, sinuses and throat must be examined to search for the source of this blood.
4. The nasal spray may be the cause as it can cause epistaxis (bleeding from the nose) due to the propellant and drying action on the nasal mucosa.
5. Sinus infection can itself cause the blood tinged phlegm. A Sinus CT is the gold standard imaging.
6. I would change the antibiotic to a penicillin group. You have not mentioned the reason for taking the coumadin, otherwise medication such as ethamsylate and tranexamic acid will help.
7. Upload your coagulogram and examination reports for further treatment options.
I hope that I have answered your query. If you have any more questions I will be available to answer them.
Regards.
Coagulogram, Sputum examination and C/S, Sinus CT, Medications.
Detailed Answer:
Hi.
Thank you for your query.
1. In about a week the effect of coumadin should not make a difference.
2. You can get a coagulogram to confirm. You can also get a sputum (phlegm) sample tested for occult blood. A bacterial + fungal culture & antibiotic sensitivity (C/S) test is also recommended.
3. If the coagulaogram is within normal limits, the nose, sinuses and throat must be examined to search for the source of this blood.
4. The nasal spray may be the cause as it can cause epistaxis (bleeding from the nose) due to the propellant and drying action on the nasal mucosa.
5. Sinus infection can itself cause the blood tinged phlegm. A Sinus CT is the gold standard imaging.
6. I would change the antibiotic to a penicillin group. You have not mentioned the reason for taking the coumadin, otherwise medication such as ethamsylate and tranexamic acid will help.
7. Upload your coagulogram and examination reports for further treatment options.
I hope that I have answered your query. If you have any more questions I will be available to answer them.
Regards.
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. Chakravarthy Mazumdar
Answered by
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