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Dr. Andrew Rynne

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What causes nasal congestion and white patches on tongue while treating sinus infection?

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Dr. Sumit Bhatti

ENT Specialist

Practicing since :1991

Answered : 2569 Questions

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Posted on Thu, 15 Oct 2015 in Ear, Nose and Throat Problems
Question: I have had the same sinus infection for almost 2 months now 3 different antibiotics and prednazone. It keeps getting worse my sinus has thick green stuck all over the inside of my nose and now my throat hurts. It has bumps all over my tongue and now white bumps too that I can scrape off. What do I do? What is this?!
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Answered by Dr. Sumit Bhatti 58 minutes later
Brief Answer:
Chronic Sinusitis.

Detailed Answer:
Hi,

Thank you for your query.

1. Since this sinus infection has not responded to medical treatment for more than 2 months it can now be termed as chronic sinusitis. I recommend the following investigations:
a. A plain CT PNS (Para Nasal Sinuses),
b. A nasal examination and video-endoscopy,
c. Nasal swabs for bacterial, fungal culture and antibiotic sensitivity.
d. Skin Prick Test (such as AllergoSPT) for Allergy, especially to aero-allergens including moulds.

2. Based on the results of these tests, further treatment options may be discussed.

3. If there is blockage and stasis of sinus and nasal secretions, it may be treated first with a trial of further medication that should include an anti-histamine (such as levocetirizine, fexofenadine), an anti-leukotriene (such as monelukast), a steroid nasal spray (mometasone, fluticasone or ciclesonide), steam inhalation and saline nasal washes.

4. If there is a resistant 'biofilm' formation, it may be treated with hypertonic (>2%) saline nasal douching, endoscopic surgery or balloon sinuplasty.

5. Upload the plain CT Scan images for an accurate assessment. Along with the tongue signs and symptoms, this seems to be a resistant bacterial or fungal sinusitis.

6. You can consult Prof. XXXXXXX Levine at the XXXXXXX Nasal Sinus & Sleep Center, Ohio for guidance.

I hope I have answered your query. If you have any further questions, I will be available to answer them.

Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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