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What Causes Recurrent Infections At The Back Of Throat And Tongue?

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Posted on Mon, 3 Aug 2015
Question: Hi, I am a 38 year old female who is 128 pounds. I do high intensity cardio every other day and feel I am in good health. I have been having what seems to be recurrent infections (abscess?) somewhere in the back of my throat or at the base on my tongue on the right side. Last year, I had an intermittent bad taste coming from the right back side near the base of my tongue that would come about once daily and last only 10-20 seconds. I was prescribed penicillin for an abscessed tooth and noticed the taste went away for a couple of weeks then returned. I visited an ENT who did made a very basic observation or my ears, nose and throat but he did not see anything. No other tests were administered. However, after I explained that the symptoms went away temporarily with the antibiotic, he put me on a three week prescription for Augmentin 875 2x a day. My symptoms completely resolved for 11 months then returned. I went to my general family physician who said she would again prescribe the Augmentin as the ENT did to see if the symptoms would again go away. They did for the time I was on the Augmentin until three weeks later when they have now returned.

Possibly associated with or relevant to this issue:
I have tight neck muscles on this side seemingly due to or exasperated by my work posture. I have also observed that my food and drink seem to be going down on the opposite (left) side of my symptoms. I have noticed my neck seems to start hurting a few days before the bad taste cycle begins. I also seem to be having some possible referred symptoms to my ear and base of skull on that side as occasional ear pain and headache.
I had an ultrasound of my thyroid and nodes on the right side last year around the same time I began having these symptoms. It noted a normal thyroid and a four small nodes in the anterior and posterior chain but they were noted to be of no concern.
The area around my submandibular gland is sore to touch.

I would really like another opinion as to what this could possibly be. I had not taken antibiotics in over a decade due to great health and not I keep getting a recurrent infection that doesn't go away without them. It has been suggested by my general physician that a CT scan is an option, but I would like to avoid unnecessary excessive radiation if possible. I feel good outside of these area specific symptoms so it is not affecting me as a whole.
My lab reports over the last year have indicated mild iron deficiency anemia. I have heavy cycles. It is getting better. Also, my WBC was noted as low at 3.3 on a CBC done in March 15. I was retested in XXXXXXX and my levels XXXXXXX to 3.7. A year ago two tests around the same time were noted at 4.3 and 4.6. My doctors did not mention any concerns related to that.
I have also noted my bun/creatinine ratio has been higher at around 22 on each test. I was told it was possibly mild dehydration so I have tried to increase my attention to staying hydrated after workouts.

I do not know if any of that information is helpful, but I wanted to share.
Thank you for your time and thoughts.
-XXXX
doctor
Answered by Dr. Sumit Bhatti (1 hour later)
Brief Answer:
VL'scopy, CBCT.

Detailed Answer:
Hi,

Thank you for your query.

1. Get a Videolaryngoscopy (VL'scopy) done. The areas of interest will be the tonsil (for any tonsillolith or chronic infection), the back of the tongue, posterior pharyngeal wall and dental problems.

2. The lymph nodes in the sub-mandibular region drain this area. Ideally the neck USG (Ultrasound) should have helped differentiate between tenderness of the submandibular salivary gland and the submandibular lymph nodes. Added to this is the fact that you tend to recover with antibiotics, means that you have a mild infection somewhere in that region, possibly the dental abscess.

3. You can get a Cone Beam CT (CBCT) Scan done if you want to avoid a full CT Scan, but this is recommended as it will help identify the source of this infection.

4. Other wise you seem to be in excellent health. Upload the results of these investigations for further treatment options.

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. Vaishalee Punj
doctor
Answered by
Dr.
Dr. Sumit Bhatti

Otolaryngologist / ENT Specialist

Practicing since :1991

Answered : 2685 Questions

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What Causes Recurrent Infections At The Back Of Throat And Tongue?

Brief Answer: VL'scopy, CBCT. Detailed Answer: Hi, Thank you for your query. 1. Get a Videolaryngoscopy (VL'scopy) done. The areas of interest will be the tonsil (for any tonsillolith or chronic infection), the back of the tongue, posterior pharyngeal wall and dental problems. 2. The lymph nodes in the sub-mandibular region drain this area. Ideally the neck USG (Ultrasound) should have helped differentiate between tenderness of the submandibular salivary gland and the submandibular lymph nodes. Added to this is the fact that you tend to recover with antibiotics, means that you have a mild infection somewhere in that region, possibly the dental abscess. 3. You can get a Cone Beam CT (CBCT) Scan done if you want to avoid a full CT Scan, but this is recommended as it will help identify the source of this infection. 4. Other wise you seem to be in excellent health. Upload the results of these investigations for further treatment options. I hope that I have answered your query. If you have any more questions I will be available to answer them. Regards.