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What Causes Recurrent Throat Infection?

Posted on Thu, 16 Oct 2014

Question: i have been experiencing repeated throat infection with foul smelling whitish subtance from my tonsil. Is that a sign of infection? I also have low Neutrophil count. What test should i do to determine if i have bacteria infection

Answered by Dr. Rakesh Madhyastha (13 minutes later)

Brief Answer:
Tuberculosis

Detailed Answer:
Hello

Thanks for the query

The fact that you are experiencing repeated throat infection asscociated with a differential count which is predominantly lymphocyte in nature means that it could be tubercular tonsilitis. Here is how you go about it

1. Get an ESR and C reactive protein, raised ESR and C reactive protein is indicative of Tuberculosis
2. I also recommend that the swab of the pus to be sent for culture and AFB staining to confirm the treatment

I must add here that treating the infection blindly will not help. You will keep getting infections over and over again.

Please follow my instructions, meet an ENT specialist as soon as possible

Regards

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

Follow up: Dr. Rakesh Madhyastha (14 minutes later)

Thank you for the reply. I have already carried out a test and the C-Reactive Protein is 6.4 (High)
In addition, i also attached a report on CBC+ESR. Are you asking that i retake the tests?
ESR is 11 mm/1hr
Just to sum up my follow on question:

1. My ESR is 11mm/1hr - considered within range for a male
2. C-Reactive Protein of 6.4 (High).

Are the above results sufficient to make the tuberculosis diagnosis or would you require additional test?

I have also been complaining about pain in my knee which i suspect is Anthritis. Is there a link?

Answered by Dr. Rakesh Madhyastha (3 hours later)

Brief Answer:
Follow up

Detailed Answer:
Hello

Sorry for the short delay in my response, it was a busy day at the hospital and I just got home

The high crp and esr indicates an ongoing infection. It is not specific for tuberculosis.

I strongly suggest that you get a culture of sputum and afb staining

Recurrent throat infection can cause arthritis especially if the infection is caused by streptococcal bacteria, but unlike tuberculosis streptococcus causes increased neutrophils and not lower them

Please approach your ENT specialist, the other option can also be tonsillectomy however this will require clinical examination

I am once again sorry for the delay

regards

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

Follow up: Dr. Rakesh Madhyastha (1 hour later)

Thank you Dr. XXXXXXX Will do as advised and hopefully, this will be resolved.

Answered by Dr. Rakesh Madhyastha (3 hours later)

Brief Answer:
Hello

Detailed Answer:
Thanks for getting back

I have discussed with you the direction your investigations should take in order to come to diagnosis. It is best done by approaching a good ENT specialist.

I wish you good health and I am once again apologizing for my previous delayed response

Regards

Note: Consult an experienced Otolaryngologist / ENT Specialist online for further follow up on ear, nose, and throat issues - Book a Call now.

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