Get your health question answered instantly from our pool of 18000+ doctors from over 80 specialties
176 Doctors Online

By proceeding, I accept the Terms and Conditions

Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

HCM Blog Instant Access to Doctors
HCM BlogQuestions Answered
HCM Blog Satisfaction

Taking antibiotic for itchy throat and swollen tongue. Found high ESR. Got fever. Cause and cure?

Answered by
Dr.
Dr. Sundar Gnanavel

Psychiatrist

Practicing since :2009

Answered : 632 Questions

default
Posted on Tue, 26 Mar 2013 in Ear, Nose and Throat Problems
Question: Hello, My brother was ill for last 25 days ., he is ESR count is still high ., Following are the events that happened. I tried to attach reports for all these details. Please let me know your opinion. Please suggest if any test needs to be done for further diagnosis. ( sorry for the bad scanning of the reports) 1)     My brother felt itching in throat took some antibiotics. Pain did not suside for next 4 days. Throat infection in fact increased., also got fever. So he visited a doctor on 5-2-2013. 2)     Doctor diagnosed that the throat infection was very heavy and even the tongue was swollen. Asked for blood report ( report attached) then He has prescribed some antibiotics . and by 14-02-2013 throat pain reduced. 3)     On early morning of 16-02-2013 ( 3:30am)my brother had very severe body pain . lasted for 3 hours . the pain was in entire body even the scalp was terribly paining. By 4 pm he had severe fever visited doctor. Doctor prescribed some medicines . However fever did not come down for next 2 days. So doctor ordered for blood test. 4)     On 18-02-2013 blood test was done. ( report attached) According to the report WBC count was 0000 cells/cu.mm and ESR was 130mm (for one hour). Doctor put him on some injections for next 5 days ( details not known). Fever came down to normal in two days. 5)     After 5 days the injections were stopped he was put on some medication ( prescription attached). But then after 2 days( 25-02-2013) he had fever again. Then blood test was done again. ( report attached). 6)     According to the report the ESR was still high 120 mm , WBC has come down. Now he has no fever ,but still on some medication., i thought i’ll take a second opinion about this case. My questions are 1)     Why ESR still high? Is he in a XXXXXXX situation.? 2)     Did we miss any diagnostic test ( like CRP). Do you suggest any now? 3)     Your comments , would like to know how did this happen , any precautions to be taken. Thanks a lot XXXXXXX
doctor
Answered by Dr. Sundar Gnanavel 36 minutes later
Hello
Thanks for your query. I understand your concern for your brother. It appears to be a bacterial pharnygeal (throat) infection. The associated process of inflammation will result in increase in ESR as well as WBC count. He was probably started on antibiotics and antihistaminergics which would address the infection and inflammatory process respectively. It is encouraging to note that he has responded well to treatment. The WBC count has come down which means infection is under control. ESR, which is an inflammatory marker will take a long time to settle down and hence there is nothing to worry on that count. CRP is not a mandatory test and has limited value. The infection was likely contracted through consumption of unclean water at some point of time. Hence drinking clean/boiled water is a good preventive strategy. Do clarify further if needed.
Regards
Dr Sundar
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
default
Follow up: Dr. Sundar Gnanavel 23 hours later
Dear Doctor,
Thank you for your quick reply., I conveyed the message to him ( he stays in a different place). But he again had fever for last two days. His doctor explained him there is some throat infection still existing. He advised to continue with the antibiotics.
This is almost a month now. He is really week now, has fever . he feels bitterness in mouth for taking food. Only when he take fruit he does not feel bitterness. For rest all type of food he feels bitterness. Is this normal ? Does throat infection take this much time to cure ( that too with complications like increase in WBC count)? Do you suggest any other tests?

Regards
XXXXXXX
doctor
Answered by Dr. Sundar Gnanavel 11 hours later
Hello......
I agree with your concern. I would suggest doing a blood culture/sensitivity along with a throat swab culture/sensitivity for diagnosing with certainity. This long a period of unresolved throat infection is indeed a bit strange. However, antibiotics need to be discontinued atleast 48 hours before culture-sensitivity tests.
Regards
Dr Sundar
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
premium_optimized

The User accepted the expert's answer

Share on
Question is related to
Diseases and Conditions ,  

Recent questions on  Fever 102f

doctor1 MD

hi doctor,iam from QATAR.My son4yr.6 months having fever since morning 38.5 degree.given calpol syrup 10ml at 5.30pm but still fever same and he...

doctor1 MD

Hi there, two days ago i recovered from a severe fever and body aches due to a throat infection all accept for being slightly dizzy at times. I...

doctor1 MD

hello doc..I have pus cells in urine around 75-80/HPF..but along with this I am suffering severe fever with chills, headache & body pains.. Could u...

doctor1 MD

i think i have uti. the first time i had pain while urinating was early in the morning yesterday. i now feel nausea and my eyes burn a little bit...

doctor1 MD

Hi Doctor, My Son is 2 year 9months, 14kgs weight he has adenoid and tonsils, he was fine from Feb to Nov 2nd week ,due to weather change he has...

doctor1 MD

Dear Dr. My Daughter 2 yrs 4 months. she was sick with stomach infection vomiting loose stools and fever and was hospitalised 15 days ago. She was...

doctor1 MD

My mother is having irregular burning sensation in hands n feet. Sometimes less, sometimes more. She is not diabetic. Her cholesterol value is 315...