Question: Hello, my 19 year old daughter returned from a trip throughout Europe of 5 weeks in duration. For the past 3 she has had fevers off and on, severe sinus symptoms including congestion, bloody discharge when blowing nose but sometimes just a nose bleed. She went into a couple of ERs and was given prednisone, Tylenol, ibuprofen and one antibiotic for a 7 day treatment. Her symptoms worsened after the course of antibiotics. She has severe headaches with light sensitivity and a stiff and painful neck which gets severe in pain. She returned 2 days ago and I took her to the ER here in XXXXXXX They did a spinal tap to rule out meningitis which they said was clear. Now she has a sever back ache to add to her list of ailments. She's been given 2 liters of fluids while there and is drinking lots of fluids at home. She's eating well and taking OTC NSAIDs. Her fever was back up this am to about 102; after 500mg Tylenol and 600 mg ibuprofen it's down to 100.3 but she's still feeling awful and crying a lot due to pain in her head, neck and back. She's also been on azithromycin for 2 days and has had one dose of Doxycycline. Should she start recovering soon? When and should we go back to the ER or Doctor? I should add she wanted to be tested for STDs but the ER isn't set up for that-although she says she doesn't have any symptoms of anything... Any advice beyond what we're currently doing?

Thank you so much for your response.

I now need to convince her it's worth her going back in since she's really tired of the hospital. However she keeps falling asleep as well and her temp after meds is staying at about 99.5. She also isn't tolerating the doxycycline after one dose. Neglected to mention she has a severe allergy to penicillins and a previous negative side effect to tetracycline. The tetracycline gave her severe stomache aches and heartburn bad enough that we went to the ER that time too. The doctor knew this but said the doxycycline would be fine but I suspect they're close enough in the same family of antibiotics that she's not going to tolerate it. We made sure she took it on a full stomach and with a glass of almond milk (lactose intolerant).

I do believe this has gone on long enough that it probably warrants her getting the IV antibiotics. I assume they would need to admit her for this? Or could she go on outpatient status and come in daily?

Anyway thanks again for your time and help!

Thank you so much for your answers and time. I sincerely appreciate it and took your advice. I brought up your message when we went back to the ER again and believe it swayed the ER doc to do most of what you suggested. He was hesitant and said he'd never seen a sinus infection that couldn't be cured by taking oral antibiotics, but he agreed to a CT scan. Once he saw that her sinuses were indeed 100% full and serious, he decided to give her the IV antibiotics. With that and a new prescription, she's finally broken her fever and turned from seriously ill to totally on the mend 48 hours later. She looks like a new person! I think we narrowly avoided a potentially serious turn from very ill to critical and I wanted to pass along my gratitude! Thanks again for your advice!