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Dr. Andrew Rynne

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Treated for sinus infection and bronchitis. Have sore throat and breathing difficulty. What's wrong?

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Dr. Naveen Kumar

ENT Specialist

Practicing since :2001

Answered : 2386 Questions

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Posted on Tue, 8 Jan 2013 in Asthma and Allergy
Question: I have been ill for the last month. First being treated for sinus infection and bronchitis with a 5 day pack of azithromycin. Two weeks later i still had sinus pressure and difficulty breathing i was then treated with prednisone. Now 4 weeks after my initial visit i still have a sore throat, swollen lymph nodes, and difficult breathing. I have been on leviquin for 5 days as well as qvar inhalor. I am not better, what else could this be?
doctor
Answered by Dr. Naveen Kumar 28 minutes later
Hi

Thanks for the query

After going through your description I do feel you are suffering from acute sinusitis and pharyngitis.

During nasal congestion, because of which there will be blockage of the sinus opening leading to stagnation of the secretions in the sinus and increased viscosity. Stagnation of the secretions gives rise to headache and nasal infection. When the infected secretions trickle down into the throat it can cause irritation of the throat, followed by cough and difficulty in swallowing.

When the infection is acute there will be associated fever, headache, cough, throat pain, difficulty in breathing, etc.

Z-pack and Levofloxacin are for milder infections which might not be effective for you.

You can try the following:
1. Drink plenty of warm water – this helps in improving the blood circulation, keeping the mucosa moist and relief from pain.
2. An antibiotic such as a combination of amoxicillin and clavulanic acid or cefuroxime for 10days.
3. An anti-inflammatory medicines such as diclofenac or ibuprofen for the relief of pain.
4. Use saline nasal spray followed by steam inhalation 3-4 times a day - this helps in removing the thick secretions from the sinuses and thus reduces the nasal block.
5. A mucolytic such as bromhexine or ambroxol – this reduces the viscosity of the sinus secretions and thus relieves the sinus pressure and cough.
6. Avoid smoking/chilled food & beverages/alcohol/coffee till you recover.
7. If you are not feeling better with the above measures, request your doctor for a CT scan of the nose and the paranasal sinuses to assess the extent of sinus blockage and study the anatomy of the nose and sinuses.

Do not worry! With the above measures you will definitely be alright.

Hope I have answered your queries; I will be available for the follow-up queries.

Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Naveen Kumar 11 minutes later
I've been prescribed amoxacillin so much that it is no longer effective. Is there another combo i should try? Also, with my history of asthma, is it not necessary to get a chest xray?
doctor
Answered by Dr. Naveen Kumar 3 hours later
Hi

Thanks for writing back

Plain amoxycillin does not work with most of the individuals, but when combined with clavulanic acid, it becomes one of the best drugs to treat sinusitis. Otherwise, you can try with cefuroxime 500mg which is better than the combination of amoxycillin and clavulanic acid.

Secondly, your asthma would have been aggravated with the onset of Hence, it is wiser to follow the above measures in order to relieve the URTI.

There is no harm in getting a chest X-ray at this juncture. But, it would be better to get it done after trying the above medications for a week.

I wish you good health

Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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