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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Can Bad Breath, And Cough Post Adenotonsillectomy Indicate Infection?

I had an adenotonsillectomy done 2 1/2 weeks ago, I still have some nasty breath and still coughing up greenish/yellow/brown mucus.. Is this normal or could this be an infection.. I am not congested at all.. I was put on zpack last week for the terrible odor, but in the past have been immune to it when tonsilitis struck and used augmentin going forward.. Is it possible I am infected and the zpack didn t work? Should I try augmentin, I have 20 from a previous bout of tonsilitis.. I have a follow up call with my dr in 2 days as I am also experiencing Velopharyngeal insufficiency now post op
Tue, 24 May 2016
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Dentist 's  Response
Hello,

I can understand your concern. You are correct in assuming presence of infection at the surgical site as foul odor and green discharge should be absent in process of normal healing. It is also true that Azithromycin (Z-Pak) did not work.

In this situation, I can give you two options. First is, you can start Augmentin which is a higher antibiotic than Azithromycin and has shown very good results in presence of post-operative infections. You can take this medicine twice a day for five days. Alternatively, you can wait for 2 days for your appointment and let the surgeon examine you physically for the presence of infection. He might ask you to go for throat culture that will detect what bacteria are responsible for the infection and which antibiotic will work best against it.

It is also possible that the regular oral hygiene measures are compromised due to surgery you have been through causing bad breath from mouth. To combat this bad odor from mouth, you can use Chlorhexidine mouthwash. You c an take 10 ml of the mouthwash liquid (undiluted) and swish it in your mouth for 30 seconds and then gargle. Do not drink or eat anything for at least 30 minutes after its use to achieve maximum benefit of the liquid.

I hope this information helps you. Thank you for choosing HCM. Let me know if you have follow up questions.

Best,
Dr. Viraj Shah
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Can Bad Breath, And Cough Post Adenotonsillectomy Indicate Infection?

Hello, I can understand your concern. You are correct in assuming presence of infection at the surgical site as foul odor and green discharge should be absent in process of normal healing. It is also true that Azithromycin (Z-Pak) did not work. In this situation, I can give you two options. First is, you can start Augmentin which is a higher antibiotic than Azithromycin and has shown very good results in presence of post-operative infections. You can take this medicine twice a day for five days. Alternatively, you can wait for 2 days for your appointment and let the surgeon examine you physically for the presence of infection. He might ask you to go for throat culture that will detect what bacteria are responsible for the infection and which antibiotic will work best against it. It is also possible that the regular oral hygiene measures are compromised due to surgery you have been through causing bad breath from mouth. To combat this bad odor from mouth, you can use Chlorhexidine mouthwash. You c an take 10 ml of the mouthwash liquid (undiluted) and swish it in your mouth for 30 seconds and then gargle. Do not drink or eat anything for at least 30 minutes after its use to achieve maximum benefit of the liquid. I hope this information helps you. Thank you for choosing HCM. Let me know if you have follow up questions. Best, Dr. Viraj Shah