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Sinus Infection In Respiratory Tract, On Antibiotics, Recurring Symptoms. Treatment ?

Posted on Sun, 10 Jun 2012

Question: Hi I would first like to say thank you for taking the time to assist. I am currently sitting with a sinus infection that basicly spread to my whole upper resp trackt. I have been on three types of antibiotica and as soon as one area clears up something else starts. I would really like to speak to a Dr. that can assist me with my symptoms. Thank you

Answered by Dr. Robert Galamaga (56 minutes later)

Hello and thanks for the query.

Generally at this point I am thinking that you may be dealing with an inflammatory process rather than purely an infectious issue.

When this is the case we often need to move outside the realm of antibiotics and consider ancillary medications which can profoundly improve the way you feel and help lead to a good resolution of the symptoms. The inflammatory process can be post-infectious or it could be due to some continued exposure to allergens such as dust, animal hair or dander or other irritants. In our case if there is no obvious environmental irritants I would consider a few different medications which may help.

The first medication which I would consider is fluticasone nasal spray. This is a topical remedy which takes 10 to 14 days to get to a therapeutic level but can generally make a significant impact on resolving symptoms and promoting relief. In addition I would consider a tapering course of prednisone which is an anti-inflammatory which helps reduce swelling in the nasal and sinus passageways as well as the chest. This medication is very safe and I would recommend a 10 to 12 day course. Lastly, an inhaler such as combivent may be used to help decrease airway spasm and cough.

Any of these or a combination of them would provide benefit for you in my opinion. You might consider talking to your doctor about this and he may be able to expand on these thoughts and or provide a prescription.

Thanks again for the query. I hope my response has served to be helpful and informative. If you have any additional concerns I would be happy to address them.

Sincerely,

Dr. Galamaga

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Robert Galamaga (35 hours later)

Hi Dr. thank you for the response. After the weekend I am surely starting to feel better although since about Saturday (for two days now) if I blow my nose I have like a small amount blood tinged in my nasal discharge. Never had nosebleeds. Just this tinged of really small blood. Also in the morning it seems to be worse as if it dried up during the night. It really scares me. The fullness I felt in my ears are gone although my sinusses still hurts especially on my cheekbones and forehead. I had this funny sensation first on the right and then on the left of my cheekbones almost like numbness and tingling although that has been gone since Saturday (three days) now. I am so concerned about perhaps having sinus cancer although I do feel it is season related. I just never had it this bad. First infection in right ear and sinus then infection in left ear and sinus then started coughing and my airway feels tight. I have been blowing less since yesterday. The phlem was a little discoloured in the beginning but has cleared up for the last week to a clear color. I have also decided to go see a ENT in the coming week although I am really scared. I dont have any severe headaches just preassure although my cheekbones makes these funny little pains. Does the blood indicate something serious. I am finished now with my antibiotics and am currently going on an allergic pill for a month. I must also say that i really sneezed alot as if when I start to sneeze I know here comes the sinusses again. A lot of post nasal drip as well although I have had this for so long. Please can you give any advice regarding all these symptoms and onnestly say if you feel if there is something serious that I have to see the ENT sooner. Thank you for your time and assistance. Regards

Answered by Dr. Robert Galamaga (19 hours later)

Hello and thanks for the followup.

Let me reassure you that it is highly highly unlikely that you have some kind of cancer causing any of your symptoms. What you are dealing with is more a concentration of allergy and inflammation which has caused the varied symptoms you have reported.

As for the bleeding in the nasal passageways this is extremely common as well and not a cuse for immediate concern. The most likely contributing factor to this is lack of humidity in the air as well as the frequent nasal drainage and nose blowing that goes along with this. I know you have not had this happen before but please find some comfort in my assurance that this is a common thing that goes along with allergic and inflammatory responses in the nasal and sinus passageways.

Seeing the ENT is fine and I am sure he will also provide you with the same reassurance.

Thanks again for the query. I hope you found my response to be helpful and informative. If you have any additional concerns I would be happy to adress them.

Sincerely,

Dr. Galamaga

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Robert Galamaga (18 hours later)

Hi Dr. I really want to thank you for your quick response and help. Yes I must admit I went back to my Dr and he subscribed me avamys a nasal steroid spray and some allergy medication. For the last two days I really have been feeling much better. The pain under my eyes and nose and cheeks is nearly gone. I can also breath better and has a dramatic change in nasal discharge nearly nothing anymore. Blood (small amount) in nasal discharge only once this morning. For your help and making me understand I really want to say thank you. If I may I just have one more question since this whole viral infection I had this feeling of swollen upper lip although it doesnt look swollen at all. Today I could feel what feels like a vein that swollen running in my upper left lip inside my mouth it is very irretating so I am pushing on it the whole time (not good cause I am propably irretating it) there is no redness no bumps doesnt look swollen no sores. Although I can feel this vein (like) thing and it is kind of little painfull. On a scale of 1 - 10 propably a 1. I really know this propably isnt serious just wanted to know if this could still be of the viral infection that needs to clear up. My lip feels swollen though and very irretated. I never had such a severe infection so it was really scary this time. Sorry to bother you with this. I really dont want to go to the Dr again as I already feel bad for going so many times this past three weeks. Any idea on what this could be about. It is on the same side where the infection was on its worse. Thank you again.

Answered by Dr. Robert Galamaga (6 hours later)

Hello and thanks for the followup.

Don't feel bad about visiting the doctor. We train to help people in need and this happens to be a time when you are in some need.

The vein or vessel that you feel is more prominent right now because of the infection and inflammation. We have tiny blood vessels which run over every inch of our body and you are feeling one now in your lip. You are corret that if you press on this it may become more inflamed so do your best to let it be for now.

Focus on relaxing, resting and allowing your immune system to focus on restoring good health and homeostasis. I am sure you will get there - just a bit more time and it will come.

Thanks again for the query and followups. Please let me know if I may be of any additional help.

Sincerely,

Dr. Galamaga

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. Radhika