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

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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/ 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
Posted Sat, 23 Mar 2013 in Ear, Nose and Throat Problems
Answered by Dr. Sundar Gnanavel 36 minutes later
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.
Dr Sundar
Above answer was peer-reviewed by
Follow-up: Taking antibiotic for itchy throat and swollen tongue. Found high ESR. Got fever. Cause and cure? 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?

Answered by Dr. Sundar Gnanavel 11 hours later
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.
Dr Sundar
Above answer was peer-reviewed by
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