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What Causes Severe Sore Throat, Nose Inflammation, Headache And Body Pain?

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Posted on Fri, 20 Feb 2015
Question: 24 year old male. Prev Hx Bacterial Sinusitis by virtual consult and filled script for Azithromycin and Naproxen. Severe Sore throat, painful swallowing, retracted ears, nose inflammation, Headache, Body aches, Chills, nose, neck, aches, etc., Had a 1gm loading dose and subsequent dose of 500mg with not much relief. Is it normal to have that much sore throat pain with Sinusitis? the way back of the throat is very very inflamed. Uvula looks wet and a little swollen. Swollen glands definite, some teeth and jaw pain. Lots of sputum in a dark green color. Lips are cracked.

Afebrile mostly. current temp is 35.8C or 96.4F
How do I make the pain stop and get rid of this nasty bug? 6/6 people in family have variations of this infection. 1/2 on Abx
Would levaquin be any better or does this sound like a resistant strep infection?

would a picture of throat be helpful?
doctor
Answered by Dr. Sumit Bhatti (38 minutes later)
Brief Answer:
Throat swab for C/S. Antibiotics as per result.

Detailed Answer:
Hi,

Thank you for your query.

1. You need a throat swab to be sent for bacterial culture and antibiotic sensitivity.

2. Any further antibiotics should be based on the result any you will benefit from targeted antibiotic therapy. Given your symptoms, there is a strong possibility of an initial viral URTI with secondary bacterial infection.

3. You are on a lot of medications currently. You should review these as you are likely to be facing multiple side effects from so many medications.

4. Your BMI seems to be very high. You need urgent treatment for the same.

5. The swollen and congested uvula may also be angioneurotic edema or due to snoring and sleep apnea. Upload a close-up image if possible.

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

Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sumit Bhatti (33 minutes later)
Despite a snow storm we are having overnight, I will try to get cultures sent out STAT for tonight or tomorrow.

I am well versed in my medications and their side effects as well as my BMI. I lost 10kg over the past 6 weeks. Ironically, the antidepressants and thyroid supplements help counteract the sedating drugs. Most of the drugs are essential and thus cannot avoid them. Constipation and drug interactions are the most of side effects and a dry mouth from the Tizanidine. However, generally things are manageable.

AHI=4.5 with median pressure 9.4 XXXXXXX pressure 15.6 cmH2O range 7-16 EPR=1

pictures will be sent. uvula looks better. Might actually be tonsils.. I am going to have to go through and look at some older videos of it.
doctor
Answered by Dr. Sumit Bhatti (10 hours later)
Brief Answer:
The images show tonsillitis.

Detailed Answer:
Hi,

Thank you for writing back.

1. The swab reports will require 3 days.

2. The images show tonsillitis, a coated geographic tongue. The Uvula is normal. Mild sub mucous fibrosis seems to be present.

3. At over two dozen medications, you need a review of the current list.

4. Augmentin (amoxicillin + clavulanate) will be a good choice for an antibiotic till you wait for the test results.

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

Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sumit Bhatti (12 hours later)
Abx are actually kicking in. I stopped using the BML compound because it wasn't doing much good, and I found out that the Maalox in it was blocking absorption. I actually have been experiencing a little diarrhea, which is new. However, considering the loading dose of antibiotics, I can see why.

submucosa fibrosis-Etiology could be from Vitamin B2 deficiency? If its something to be concerned about, I can request the lab order and get riboflavin supplements if you can advise me on the dosage for it. Nice Catch.

Geographic tongue-noted. any Tx for that? I will review all medications with all of my specialists to ensure the need for medical necessity. Unfortunately, most of them are.

Thanks for all of your help.
doctor
Answered by Dr. Sumit Bhatti (12 hours later)
Brief Answer:
Multivitamin B-Complex + Zinc. Tongue condition is benign.

Detailed Answer:
Hi,

Thank you for writing back.

1. Good to hear that the antibiotics are working.

2. A multivitamin containing B-Complex and Zinc will be fine.

3. These tongue conditions are benign. The treatment usually consists of anti-fungal, anti-allergic, anti-reflux , steroid, anti-anxiety medications and multivitamins. Local application creams may help. Check on any new foodstuff and toothpaste.

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

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. Raju A.T
doctor
Answered by
Dr.
Dr. Sumit Bhatti

Otolaryngologist / ENT Specialist

Practicing since :1991

Answered : 2685 Questions

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What Causes Severe Sore Throat, Nose Inflammation, Headache And Body Pain?

Brief Answer: Throat swab for C/S. Antibiotics as per result. Detailed Answer: Hi, Thank you for your query. 1. You need a throat swab to be sent for bacterial culture and antibiotic sensitivity. 2. Any further antibiotics should be based on the result any you will benefit from targeted antibiotic therapy. Given your symptoms, there is a strong possibility of an initial viral URTI with secondary bacterial infection. 3. You are on a lot of medications currently. You should review these as you are likely to be facing multiple side effects from so many medications. 4. Your BMI seems to be very high. You need urgent treatment for the same. 5. The swollen and congested uvula may also be angioneurotic edema or due to snoring and sleep apnea. Upload a close-up image if possible. I hope that I have answered your query. If you have any more questions I will be available to answer them. Regards.