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What Causes Sore Throat, Swallowing Difficulty, Laryngitis, Left Hand Knuckles Pain And Headache?
Question: My wife is a 68 year old woman and started with a sore throat and difficulty swallowing on October 30. On November 1, we went to urgent care and her temperature was 99.6, BP 100/74, pulse 86. The doctor on duty prescribed a z-pak antibiotic. Later in the day, her blood pressure was 121/87 with a plus of 88 and her temperature was 100.1. She complained about her swallowing, laryngitis,pain in her left hand knuckles and headache. Today, the sore throat, swallowing, headache, temperature of 98.0, BP 14/95, pulse 87, persist. Added problems are bad smelling gas, nausea, anxiety, confusion (she took a shower with her socks on and didn't realize in until she got out) and leg pain/weakness. She has been through many health issues and surgeries over the past 15 years and is refusing to go to a doctor right now. Any ideas would be helpful
Brief Answer:
Needs workup for sepsis and another antibiotic cover
Detailed Answer:
Hi! Welcome to health care magic!
Thanks for sharing your concerns. Based on the history you have shared, the significant findings which can raise many eyes brows are fever with confusion and difficulty swelling. Signs of upper respiratory tract infection can explain difficulty swelling called odynophagia due to throat inflammation or tonsillitis, but if persist for weeks and is associated with any weight loss or vomiting will need detailed work up for obstructive causes. Other symptoms like gas, bloating and nausea are concerned these can be due to Z pack itself or part of the illness. Most significant and worth taking care of, is the confusion and that can be due to sepsis secondary to lower respiratory tract involvement or urinary tract infection. In elderly infection or sepsis present with features of confusion or altered senssorium quite often.
She may need to have blood screening tests if such symptoms persist, though she is afraid to visit hospital but yiu will have to convince her for that, as a through workup with complete blood count, cultures is possible alongwith urinannalysis and chest Xray might ne needed. Meanwhile continue Z pack as it is only 3rd day and temperature is settled today which is a good sign. For gastric symptoms she can use antacids like omeperazole and motility agents like domperidone for feeling better. Meanwhile give her soft diets and more hot beverages or fluids like soups etc for calorie requirement as well as easy compliance due to throat symptoms. she also need to use anti histamines like cetrizine for a better outcome regarding her throat symptoms alongwith anti inflammatory or anti pyre tics like acetaminophen or ibuprofen thrice daily to avoid fever spikes and reduce swelling, pains and inflammation in the throat. If confusion persists she may need to be taken to hospital for nervous system infections like meningoencephalitis.
Hoping her a speedy recovery. If you have any more questions, feel free to ask else kindly close the discussion. You can also reach me directly through my profile in future, in case of any more questions, Regards.
Needs workup for sepsis and another antibiotic cover
Detailed Answer:
Hi! Welcome to health care magic!
Thanks for sharing your concerns. Based on the history you have shared, the significant findings which can raise many eyes brows are fever with confusion and difficulty swelling. Signs of upper respiratory tract infection can explain difficulty swelling called odynophagia due to throat inflammation or tonsillitis, but if persist for weeks and is associated with any weight loss or vomiting will need detailed work up for obstructive causes. Other symptoms like gas, bloating and nausea are concerned these can be due to Z pack itself or part of the illness. Most significant and worth taking care of, is the confusion and that can be due to sepsis secondary to lower respiratory tract involvement or urinary tract infection. In elderly infection or sepsis present with features of confusion or altered senssorium quite often.
She may need to have blood screening tests if such symptoms persist, though she is afraid to visit hospital but yiu will have to convince her for that, as a through workup with complete blood count, cultures is possible alongwith urinannalysis and chest Xray might ne needed. Meanwhile continue Z pack as it is only 3rd day and temperature is settled today which is a good sign. For gastric symptoms she can use antacids like omeperazole and motility agents like domperidone for feeling better. Meanwhile give her soft diets and more hot beverages or fluids like soups etc for calorie requirement as well as easy compliance due to throat symptoms. she also need to use anti histamines like cetrizine for a better outcome regarding her throat symptoms alongwith anti inflammatory or anti pyre tics like acetaminophen or ibuprofen thrice daily to avoid fever spikes and reduce swelling, pains and inflammation in the throat. If confusion persists she may need to be taken to hospital for nervous system infections like meningoencephalitis.
Hoping her a speedy recovery. If you have any more questions, feel free to ask else kindly close the discussion. You can also reach me directly through my profile in future, in case of any more questions, 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. Sonia Raina
Answered by
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