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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Remedy For Sore Throat

Good morning Doctor. My boyfriend (50yrs of age) aquired a sore throat, let it go for about a week...gargling n soups. seemed to get worse so went to a clinic and was prescribed a v pac i believe. He had an allergic reaction, went to emergency room was prescribed pennacillian. It was getting worse where he could not sleep. So off to the emergency room this morning. They proceded to tell him he has angioedema and was to be admitted ASAP. 70% fatal I m confused isn t andioedema from allergic reactin. His throat is unbearable, very hard to speak. He is a smoker. please help me understand what these doctors are thinking and if they are correct in their diagnosis Thank You, Sincerely, Allison Airington                                                                  
Mon, 6 Oct 2014
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  User's Response
Hi, thanks for posting the concern in the HCM.
You are absolutely right about the fact that angioedema is a very serious form of allergy or hypersensitivity reaction. It should be managed in a critical care unit under supervision of an ENT surgeon and critical care specialist.
First of all, the initial symptoms I think were due to some viral or bacterial infection. Perhaps some medication, (penicillin is also notorious for producing serious allergic reactions) may have produced the florid manifestation of the hypersensitivity reaction. The condition has particularly become serious because your boyfriend had prior throat problem.
Now that this unfortunate event has happened, I think the following should be maintained-
1. STOP all medications immediately which were used before the onset of allergic reaction.
2. Parenteral antihistaminics and steroids may be needed to resolve the angioedema immediately. Endotracheal intubation or tracheostomy and tracheal intubation may be needed if airway cannot be secured with conservative management.
3. Antibiotic therapy, other than penicillin, cephalosporin and related groups, may be used after prior skin test after stabilization of the patient.
Complete bllod count, urea, creatinine, electrolytes, CRP, IgE level should be measured. A throat swab should be sent for culture sensitivity testing.
Finally, please don't be anxious. Your doctors have correctly diagnosed the condition and there is good chance that he will come round if treated properly.
For any further help, please write back to me directly.
Regards.
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Suggest Remedy For Sore Throat

Hi, thanks for posting the concern in the HCM. You are absolutely right about the fact that angioedema is a very serious form of allergy or hypersensitivity reaction. It should be managed in a critical care unit under supervision of an ENT surgeon and critical care specialist. First of all, the initial symptoms I think were due to some viral or bacterial infection. Perhaps some medication, (penicillin is also notorious for producing serious allergic reactions) may have produced the florid manifestation of the hypersensitivity reaction. The condition has particularly become serious because your boyfriend had prior throat problem. Now that this unfortunate event has happened, I think the following should be maintained- 1. STOP all medications immediately which were used before the onset of allergic reaction. 2. Parenteral antihistaminics and steroids may be needed to resolve the angioedema immediately. Endotracheal intubation or tracheostomy and tracheal intubation may be needed if airway cannot be secured with conservative management. 3. Antibiotic therapy, other than penicillin, cephalosporin and related groups, may be used after prior skin test after stabilization of the patient. Complete bllod count, urea, creatinine, electrolytes, CRP, IgE level should be measured. A throat swab should be sent for culture sensitivity testing. Finally, please don t be anxious. Your doctors have correctly diagnosed the condition and there is good chance that he will come round if treated properly. For any further help, please write back to me directly. Regards.