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Suggest Treatment For Sore Throat, Fever And Joint Pain
Question: I am getting repeated occurance of Sore throat with fever from last one year almost once in three months. I got the aso titre checked as per doctors suggestion which is 319 last year and this year its 292. I checked with ENT doctor as my tonsils are swollen and he said aso may not have signifidance to be considered at this age of 35 and prescribed with Montek LC and antibiotic(Clavam) Amoxicylin with Potassium clauvaunate. Recently as I also have joint pains as per my ortho suggestion had done the Arthritis profile which indicated ANA as 0.84 ,RF 11 and Anti CCP as negative and ASO 292. Two days back attending a wedding function outside and having cold water I got again the sore throat with fever and was prescribed with Azithromycin and I asked the doctor whether ASO 292 is causing this he said it could be and was prescribed with Azithromycin. How can I get the ASO level reduced and decrease the sore throat occurance. Also in one of my ECHO tests earlier 5 yrs back it was identified 3mm mild mml leaflets on mitral valve. Also I checked with rheumatologist earlier an year back not with the recent test results on ASO level and he said I may have minor arthralgia and he also has not considered ASO. He checked me and declared clinically normal and prescribed REjoint and Omega 3 fatty acids for one month and asked me to check RF,AntiCCP and ANA which I have done and need to visit him again
Brief Answer:
? cause of recurrent sore throat
Detailed Answer:
Good morning there
Thank you for writing on health care magic
I have gone through your history. But what I want to assure you is not to go after ASO titres. In XXXXXXX it is a very common misconception which we come across everyday.half the patients who present with joint pains are found to have raised ASO and they are given pentid tablets or penicillin injections for a good period of 5 years or so. Aso is a very non specific test to diagnose streptococcal infection. As it happens, lot of people have the levels raised but the implications of raised aso has to fit in with the symptom's
As for your sore throat, some people s tonsils are much more prone to infection. They serve as a reservoir of infection and tend to get infected by any small event as well. You need to build up on your immunity for it and it will eventually improve.
As for the joint pains, next time do check your vitamin D levels as well. The arthritis related to rf CCP and Ana presents very differently. It is more of a persistent one with swelling and early morning stiffness. But never the less, I would like to examine the joints before giving a final diagnosis. From the information you have told it seems like non inflammatory one
Finally I would suggest you not yo chase aso titres. Just focus on strengthning your immune system with multi vitamins. Consult.your rheumatologist and get vitamin d. Levels done
Hope the information was useful
Regards
Dr naval
? cause of recurrent sore throat
Detailed Answer:
Good morning there
Thank you for writing on health care magic
I have gone through your history. But what I want to assure you is not to go after ASO titres. In XXXXXXX it is a very common misconception which we come across everyday.half the patients who present with joint pains are found to have raised ASO and they are given pentid tablets or penicillin injections for a good period of 5 years or so. Aso is a very non specific test to diagnose streptococcal infection. As it happens, lot of people have the levels raised but the implications of raised aso has to fit in with the symptom's
As for your sore throat, some people s tonsils are much more prone to infection. They serve as a reservoir of infection and tend to get infected by any small event as well. You need to build up on your immunity for it and it will eventually improve.
As for the joint pains, next time do check your vitamin D levels as well. The arthritis related to rf CCP and Ana presents very differently. It is more of a persistent one with swelling and early morning stiffness. But never the less, I would like to examine the joints before giving a final diagnosis. From the information you have told it seems like non inflammatory one
Finally I would suggest you not yo chase aso titres. Just focus on strengthning your immune system with multi vitamins. Consult.your rheumatologist and get vitamin d. Levels done
Hope the information was useful
Regards
Dr naval
Above answer was peer-reviewed by :
Dr. Yogesh D
Thanks Naval for your response.
ANA as 0.84 above the limit in the medium range ,RF 11 < 15 and Anti CCP as negative and ASO 292.
D-Vitamin - 41.49; B12 -- 589
As part of Arhrtitis profile D- Vitamin is also checked which is 41.49 and B12 is 589. I am taking Uprise d3 60k monthly once prescribed by my rheumatologist. I am taking daily Inderal 20 mg(prescribed by cardiologist); COQ Forte, Supradyn (prescribed by Rheumatologist) .I don't have any swelling in joints , but have morning stiff XXXXXXX but however when I walk or take steps I am getting knee pain and pain especially in the muscles between Knee and Foot joint after walking certain distance. Ortho suggested cycling for the same with high seat so that knee joint is not hurt and enough exercise I get for those muscles, I thought of it as some peripheral vascular decease. I have mild BP 140/90 and palpitations for which I am taking Inderal 40mg and occasional sudden slowdown of heartbeats when I press down my neck on chest portion. Also when I stand up after meditation or from morning sleep I will get palpitations. I have a Rheumatologist appointment in another two days. However I mentioned above my general conditions which will give you a full picture. Please review and let me know your opinion
Please check the attached reports of my tests which contains deviations for CRP protein, ANA , BUN ratio and PlatelettoLargeCellRatio(14.2),ASO Titre...
ANA as 0.84 above the limit in the medium range ,RF 11 < 15 and Anti CCP as negative and ASO 292.
D-Vitamin - 41.49; B12 -- 589
As part of Arhrtitis profile D- Vitamin is also checked which is 41.49 and B12 is 589. I am taking Uprise d3 60k monthly once prescribed by my rheumatologist. I am taking daily Inderal 20 mg(prescribed by cardiologist); COQ Forte, Supradyn (prescribed by Rheumatologist) .I don't have any swelling in joints , but have morning stiff XXXXXXX but however when I walk or take steps I am getting knee pain and pain especially in the muscles between Knee and Foot joint after walking certain distance. Ortho suggested cycling for the same with high seat so that knee joint is not hurt and enough exercise I get for those muscles, I thought of it as some peripheral vascular decease. I have mild BP 140/90 and palpitations for which I am taking Inderal 40mg and occasional sudden slowdown of heartbeats when I press down my neck on chest portion. Also when I stand up after meditation or from morning sleep I will get palpitations. I have a Rheumatologist appointment in another two days. However I mentioned above my general conditions which will give you a full picture. Please review and let me know your opinion
Please check the attached reports of my tests which contains deviations for CRP protein, ANA , BUN ratio and PlatelettoLargeCellRatio(14.2),ASO Titre...
Brief Answer:
? Is it Arthritis
Detailed Answer:
Good evening
Thank you for your reply
Well i have gone through your reports and nothing seems too alarming. The inflammatory markers, ESR and CRP are fairly normal. RF and Anti CCP are negative. Complements are normal. ANA is borderline but that method is obsolete now. We normally use Immunofluroscence but i dont think you need it at this stage either.
Considering your joint pains and the mitral Valve Prolapse associated, I am suspecting Joint Laxity, that is the ligaments are a bit loose which cause these pain symptoms. I am not sure here, but i suspect you can bend and touch the down floor easily without bending your knees.
I really dont think you have Rheumatic fever or anything , so one thing you need to do is to stop monitoring ASO. Your age is way beyond Rheumatic Fever.
Secondly, consult a good ENT Specialist. He might be able to help you with the sore throat you are experiencing which will should sort out the issue.
Thirdly, when you meet your Rheumatologist do ask him to check for loose ligaments.
Do let me know for more queries
Would be happy to help you out
But i assure you there is not much reason to worry here
Regards
Dr Naval
? Is it Arthritis
Detailed Answer:
Good evening
Thank you for your reply
Well i have gone through your reports and nothing seems too alarming. The inflammatory markers, ESR and CRP are fairly normal. RF and Anti CCP are negative. Complements are normal. ANA is borderline but that method is obsolete now. We normally use Immunofluroscence but i dont think you need it at this stage either.
Considering your joint pains and the mitral Valve Prolapse associated, I am suspecting Joint Laxity, that is the ligaments are a bit loose which cause these pain symptoms. I am not sure here, but i suspect you can bend and touch the down floor easily without bending your knees.
I really dont think you have Rheumatic fever or anything , so one thing you need to do is to stop monitoring ASO. Your age is way beyond Rheumatic Fever.
Secondly, consult a good ENT Specialist. He might be able to help you with the sore throat you are experiencing which will should sort out the issue.
Thirdly, when you meet your Rheumatologist do ask him to check for loose ligaments.
Do let me know for more queries
Would be happy to help you out
But i assure you there is not much reason to worry here
Regards
Dr Naval
Above answer was peer-reviewed by :
Dr. Prasad
Thank you very much Naval! It has cleared the myths about RHD and ASO.
I will definitely check with Rheumatologist on Joint laxity. I am able to touch the floor without bending my knees with a little pain in knees. Also I can touch my head on to knees while doing so.
Two years back as part of fertility test I have DNA fragmentation test done and the DNA Fragmentation index came as 34 which is greater than 30. The increase of the fragementation index shows that there will be chances of inception of disceases like Arthritis, the same I was told by the infertility specialist.
Also one more observation is when I visit cold countries I am having the throat pain and followed by fever attacked. Is the ASO raise due to cold envvironments causing this. I faced the trouble also I could not get any antibiotic like Azithromicin there as they wont issue with out doctor prescription , just I managed with Licocaine gargling solution. I am also having plans to shift to foreign country which is colder , will that be a risk based on my body condition. What are the precautionary measures you suggest.
I will definitely check with Rheumatologist on Joint laxity. I am able to touch the floor without bending my knees with a little pain in knees. Also I can touch my head on to knees while doing so.
Two years back as part of fertility test I have DNA fragmentation test done and the DNA Fragmentation index came as 34 which is greater than 30. The increase of the fragementation index shows that there will be chances of inception of disceases like Arthritis, the same I was told by the infertility specialist.
Also one more observation is when I visit cold countries I am having the throat pain and followed by fever attacked. Is the ASO raise due to cold envvironments causing this. I faced the trouble also I could not get any antibiotic like Azithromicin there as they wont issue with out doctor prescription , just I managed with Licocaine gargling solution. I am also having plans to shift to foreign country which is colder , will that be a risk based on my body condition. What are the precautionary measures you suggest.
Brief Answer:
Recurrent throat pain
Detailed Answer:
Good evening
Thanx for your reply
Well the recurrent tonsils you are having, you need to check it with an ENT surgeon once on what they feel. If they keep getting infected, they are probably serving as a source and reservoir of infection. So you should follow it up with ENT once during the episode. Sometimes removal is the best cure as it removes all the harboring infection.
As for the joint laxity, it is quite obvious from the flexibility you have. It is nothing to be worried about. Just be careful about strenuous exercises as the recovery will be prolonged.
Precautionary measures are nothing as such. Just get the tonsils checked once and take some multi vitamins to boost your immunity.
Hope the information was useful
Do buzz me for more queries
Regards
Dr Naval
Recurrent throat pain
Detailed Answer:
Good evening
Thanx for your reply
Well the recurrent tonsils you are having, you need to check it with an ENT surgeon once on what they feel. If they keep getting infected, they are probably serving as a source and reservoir of infection. So you should follow it up with ENT once during the episode. Sometimes removal is the best cure as it removes all the harboring infection.
As for the joint laxity, it is quite obvious from the flexibility you have. It is nothing to be worried about. Just be careful about strenuous exercises as the recovery will be prolonged.
Precautionary measures are nothing as such. Just get the tonsils checked once and take some multi vitamins to boost your immunity.
Hope the information was useful
Do buzz me for more queries
Regards
Dr Naval
Note: For further information on diet changes to reduce allergy symptoms or to boost your immunity, Ask here.
Above answer was peer-reviewed by :
Dr. Ashwin Bhandari
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