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Suggest Treatment For Chronic Sinusitis And Allergic Rhinitis
Question: Hi there I have a few questions I would like to ask.
I am currently on Azithromycin. The dose given to me by the doctor was 250mg a day for 6 days and then 250mg three times a week. This is for treatment of inflamation of my throat and sinus. I have a very red throat (not sore), my right tonsil is inflammed and my sinus is inflamed, causing tightness throughout my face. I have been told I have no infection, just inflammation. And I have been given the above course of Azithromycin in order to bring down the inflammation.
I have the following questions.
1. how long would it take for the inflammation to go down? As I have been on this course for 5 weeks now, and have seen no change in the above mentioned symptoms.
2. How can my throat, tonsils and sinus be inflamed when I have no infection? If it is not a bacterial infection, what else can it be?
I have no fever, and do not feel sick. however, what i do feel, is constant fatigue, I have blurred vision from time to time, and my mind feels very foggy, it is very hard to concentrate and I feel very spaced out. I had these symptoms before i started taking the azithromycin.
This all came about during a lung infection that I had, which I took augmentin duo forte for (for 20 days) that eventualyl went away however turned into tonsilitis/pharyngitis (while I was on antibiotics), since then my throat has never fully cleared up (the majority of puss on my tonsils is gone, however there is still inflamation and some specs of what looks like puss, however the doctor sais it is not an ifnection)
My blood tests originally showed that I had an infection as I had a high white blood cell count (12.6), however later blood tests showed that my white blood count was normal.
I have taken the following antioibtics.
Augmentin duo forte - 30 days
Erythomycin - 2 weeks
Abocillin - 2 weeks
Clarithromycin - 10 days
all of which were not succesfull. My infection did however eventually go away, but the inflammation has not gone down.
3. Would it be beneficial asking the doctor for something like Levofloxacin or Gemifloxacin or some other antibiotic to clear out whatever is causing the inflamation? As I have a feeling that there is a small infection still in my mouth that has not been killed off by the antibiotics.
4. Could this be the result of a fungal infection?
5. I have done a lot of blood and swab tests. Including test for Chlamydia and Gonorrhea, which have all come back negative. Are there any other specific bacteria I should ask the doctor to test for?
I am currently on Azithromycin. The dose given to me by the doctor was 250mg a day for 6 days and then 250mg three times a week. This is for treatment of inflamation of my throat and sinus. I have a very red throat (not sore), my right tonsil is inflammed and my sinus is inflamed, causing tightness throughout my face. I have been told I have no infection, just inflammation. And I have been given the above course of Azithromycin in order to bring down the inflammation.
I have the following questions.
1. how long would it take for the inflammation to go down? As I have been on this course for 5 weeks now, and have seen no change in the above mentioned symptoms.
2. How can my throat, tonsils and sinus be inflamed when I have no infection? If it is not a bacterial infection, what else can it be?
I have no fever, and do not feel sick. however, what i do feel, is constant fatigue, I have blurred vision from time to time, and my mind feels very foggy, it is very hard to concentrate and I feel very spaced out. I had these symptoms before i started taking the azithromycin.
This all came about during a lung infection that I had, which I took augmentin duo forte for (for 20 days) that eventualyl went away however turned into tonsilitis/pharyngitis (while I was on antibiotics), since then my throat has never fully cleared up (the majority of puss on my tonsils is gone, however there is still inflamation and some specs of what looks like puss, however the doctor sais it is not an ifnection)
My blood tests originally showed that I had an infection as I had a high white blood cell count (12.6), however later blood tests showed that my white blood count was normal.
I have taken the following antioibtics.
Augmentin duo forte - 30 days
Erythomycin - 2 weeks
Abocillin - 2 weeks
Clarithromycin - 10 days
all of which were not succesfull. My infection did however eventually go away, but the inflammation has not gone down.
3. Would it be beneficial asking the doctor for something like Levofloxacin or Gemifloxacin or some other antibiotic to clear out whatever is causing the inflamation? As I have a feeling that there is a small infection still in my mouth that has not been killed off by the antibiotics.
4. Could this be the result of a fungal infection?
5. I have done a lot of blood and swab tests. Including test for Chlamydia and Gonorrhea, which have all come back negative. Are there any other specific bacteria I should ask the doctor to test for?
Brief Answer:
Chronic Sinusitis with Allergic Rhinitis.
Detailed Answer:
Welcome to Healthcaremagic.
Hi, I am Dr Anshul Varshney , I have read your query in detail , I understand your concern.
This is simply Allergic Sinusitis which might be associated with Allergic bronchitis.
Following are your answers:
1. Chronic Allergic conditions persists for long and if the allergen is not removed, they may persist for life long.
2. Inflammation can occur due to allergic response and not necessarily bacterial infection.
3. No point of taking antibiotics.
4. fungal infection would be considered, if you have diabetes, persisting weight loss and fever.
5. Yes, you should go ahead for further testing as discussed below.
I would advise you to get following investigations done:
1. CT Para Nasal Sinuses
2. Absolute Eosinophil count.
3. Serum IgE levels.
I advise following treatment in such scenario:
1. To do steam inhalation 4-6 times a day.
2. To take anti allergic like Levocetrizine with Montelukast that would help you in long term.
3. In cases, who don't respond to anti allergic drugs, Fluticasone Nasal spray helps greatly.
This is my personal opinion based on details available here. If you still have any other query, you may please ask me.
Stay Healthy.
Dr Anshul Varshney , MD
Chronic Sinusitis with Allergic Rhinitis.
Detailed Answer:
Welcome to Healthcaremagic.
Hi, I am Dr Anshul Varshney , I have read your query in detail , I understand your concern.
This is simply Allergic Sinusitis which might be associated with Allergic bronchitis.
Following are your answers:
1. Chronic Allergic conditions persists for long and if the allergen is not removed, they may persist for life long.
2. Inflammation can occur due to allergic response and not necessarily bacterial infection.
3. No point of taking antibiotics.
4. fungal infection would be considered, if you have diabetes, persisting weight loss and fever.
5. Yes, you should go ahead for further testing as discussed below.
I would advise you to get following investigations done:
1. CT Para Nasal Sinuses
2. Absolute Eosinophil count.
3. Serum IgE levels.
I advise following treatment in such scenario:
1. To do steam inhalation 4-6 times a day.
2. To take anti allergic like Levocetrizine with Montelukast that would help you in long term.
3. In cases, who don't respond to anti allergic drugs, Fluticasone Nasal spray helps greatly.
This is my personal opinion based on details available here. If you still have any other query, you may please ask me.
Stay Healthy.
Dr Anshul Varshney , MD
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Thank you for your help!
This started off as an infection. I had a chest infection, and whilst on Augmentin duo forte, I developed tonsillitis. Since then I have taken all those above mentioned antibiotics which took around a month for the infection to go away, however, the symptoms have still stayed. ie the tightness, fatigue, red throat, blurred vision. The puss looking stuff on my tonsils are still there, however the doctor sais that is inflammation, and not puss. I find this strange because whenever I have had tonsillitis in the past, all the inflammation usually goes away by the 3 or 4th day of antibiotics. In this case it has stayed for around 2 months now with no signs of disappearing. Could this be a sign of a small infection still lingering on my tonsils that is not being picked up by blood tests?
Also how long would it take for the azithromycin to help the inflammation go down? I have been taking it for going on 6 weeks now, and see very minor improvements, if any at all.
This started off as an infection. I had a chest infection, and whilst on Augmentin duo forte, I developed tonsillitis. Since then I have taken all those above mentioned antibiotics which took around a month for the infection to go away, however, the symptoms have still stayed. ie the tightness, fatigue, red throat, blurred vision. The puss looking stuff on my tonsils are still there, however the doctor sais that is inflammation, and not puss. I find this strange because whenever I have had tonsillitis in the past, all the inflammation usually goes away by the 3 or 4th day of antibiotics. In this case it has stayed for around 2 months now with no signs of disappearing. Could this be a sign of a small infection still lingering on my tonsils that is not being picked up by blood tests?
Also how long would it take for the azithromycin to help the inflammation go down? I have been taking it for going on 6 weeks now, and see very minor improvements, if any at all.
Brief Answer:
Just Anti Allergic
Detailed Answer:
Hello, The antibiotics won't help you in this redness as this is not due to infection.
This is allergic.
So, as discussed, you just need anti allergic like Levocetrizine for long term.
Continue with steam inhalation.
You don't need any antibiotics based on this history.
If you have any further query, please ask me.
Just Anti Allergic
Detailed Answer:
Hello, The antibiotics won't help you in this redness as this is not due to infection.
This is allergic.
So, as discussed, you just need anti allergic like Levocetrizine for long term.
Continue with steam inhalation.
You don't need any antibiotics based on this history.
If you have any further query, please ask me.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you for you help.
I don't have any of the above mentioned nasal sprays, however I have been given two sprays by two different doctors. One is 0.11% dexamethasone nasal spray and the other is a combination of azalestine and fluticasone propionate.
Which one of these would you say is the best one to use? i.e. which would give the fastest results?
I don't have any of the above mentioned nasal sprays, however I have been given two sprays by two different doctors. One is 0.11% dexamethasone nasal spray and the other is a combination of azalestine and fluticasone propionate.
Which one of these would you say is the best one to use? i.e. which would give the fastest results?
Brief Answer:
Both are good.
Detailed Answer:
Hello, I would personally recommend and in fact I prefer to use in my patients the spray containing Azelastine and Fluticasone.
Start using the spray with other treatment options discussed, you would get relief in a few days.
I hope it helps you.
If you have any further query, please ask me.
Both are good.
Detailed Answer:
Hello, I would personally recommend and in fact I prefer to use in my patients the spray containing Azelastine and Fluticasone.
Start using the spray with other treatment options discussed, you would get relief in a few days.
I hope it helps you.
If you have any further query, please ask me.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Can I use both? or would that do more damage than good??
The thing is that I have been using the dexamesthasone for a while now, maybe 2 weeks, and i haven't seen that much improvement. It is getting better, but very slowly. How long would this take to get better?
The main issue I have is the foggy/unable to concentrate feeling, along with the blurred vision. They dont seem to be going away anytime soon.
The thing is that I have been using the dexamesthasone for a while now, maybe 2 weeks, and i haven't seen that much improvement. It is getting better, but very slowly. How long would this take to get better?
The main issue I have is the foggy/unable to concentrate feeling, along with the blurred vision. They dont seem to be going away anytime soon.
Brief Answer:
No use one.
Detailed Answer:
Hello. Actually both the sprays contain steroids.
So taking both the sprays would cause more side effects.
You have to be patient.
I would advice you to use Azelatine and Fluticasone spray and stop Dexamethasone spray.
Good luck.
No use one.
Detailed Answer:
Hello. Actually both the sprays contain steroids.
So taking both the sprays would cause more side effects.
You have to be patient.
I would advice you to use Azelatine and Fluticasone spray and stop Dexamethasone spray.
Good luck.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you.
Do you mind if i ask why you prefer the azelastine and fluticasone spray?
Over the years I have alternated between the two. as I do have a sinus problem, however has never been this sever, usually I start developing yellow mucus, and start spraying gentamicin and dexamethasone spray and symptoms would go away in about 5 days. I have never had anything this severe though, nor with these symptoms.
Usually i would use the fluticasone spray (no azelastine) and i found it did not do much for me, which is why I have been using the dexamethasone spray.
How exactly would the azelastine help in this situation?
Apologies for asking so many questions, but this has been going on for over 3 months now and is severely impacting my life. I need to get this fixed as fast as possible.
Do you mind if i ask why you prefer the azelastine and fluticasone spray?
Over the years I have alternated between the two. as I do have a sinus problem, however has never been this sever, usually I start developing yellow mucus, and start spraying gentamicin and dexamethasone spray and symptoms would go away in about 5 days. I have never had anything this severe though, nor with these symptoms.
Usually i would use the fluticasone spray (no azelastine) and i found it did not do much for me, which is why I have been using the dexamethasone spray.
How exactly would the azelastine help in this situation?
Apologies for asking so many questions, but this has been going on for over 3 months now and is severely impacting my life. I need to get this fixed as fast as possible.
Brief Answer:
Milder Steroids are better.
Detailed Answer:
Hi. You need not to say sorry and you can ask me as many questions you have in your mind.
I prefer to use Fluticasone over Dexamethasone because it is a minster steroid. Steroids give you immense relief but also compromise your immunity.
If you keep on using the potent steroids for very long term you would not get relief with lighter medications and probably this is what is happening.
I would recommend you to be patient and take the medicine as adviced.
If you have any further query, please ask me.
Milder Steroids are better.
Detailed Answer:
Hi. You need not to say sorry and you can ask me as many questions you have in your mind.
I prefer to use Fluticasone over Dexamethasone because it is a minster steroid. Steroids give you immense relief but also compromise your immunity.
If you keep on using the potent steroids for very long term you would not get relief with lighter medications and probably this is what is happening.
I would recommend you to be patient and take the medicine as adviced.
If you have any further query, please ask me.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you. I have been using dexamethasone spray for a few years now. Maybe 3 years or so, on and off.
I have some valium that I would like to take in order to get rid of the anxiety I have been experiencing. Will this react with the azithromycin? I see that there are interactions with erythromycin, so not sure whether I should take it.
Also, I seem to have a history with getting infections (tonsillitis, chest infections) after taking long flights. For example, if i take a flight from Australia to Europe, I will definitely come down with an infection a few days after arriving in europe. This has happened everytime I fly over the last few years. Is there any way I can prevent this from happening? or minimize my chances?
I have some valium that I would like to take in order to get rid of the anxiety I have been experiencing. Will this react with the azithromycin? I see that there are interactions with erythromycin, so not sure whether I should take it.
Also, I seem to have a history with getting infections (tonsillitis, chest infections) after taking long flights. For example, if i take a flight from Australia to Europe, I will definitely come down with an infection a few days after arriving in europe. This has happened everytime I fly over the last few years. Is there any way I can prevent this from happening? or minimize my chances?
Brief Answer:
Continue as adviced
Detailed Answer:
Hello,
Valium has no significant interactions with 5 days therapy of azithromycin.
So, now since your Azithromycin is stopped, you may continue with Valium.
The change in weather and atmosphere might be related to developing allergies as well, but treatment remains the same.
So, an anti allergic, Fluticasone nasal spray and Steam are the best judge for you.
Good Luck.
Continue as adviced
Detailed Answer:
Hello,
Valium has no significant interactions with 5 days therapy of azithromycin.
So, now since your Azithromycin is stopped, you may continue with Valium.
The change in weather and atmosphere might be related to developing allergies as well, but treatment remains the same.
So, an anti allergic, Fluticasone nasal spray and Steam are the best judge for you.
Good Luck.
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
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