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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Have Cold With Sore Throat. Nothing Found In Throat Culture. Took Amoxicillin. Vomited Blood. Reason?

Hello Dr, My name is Kirk. I am a 27 year old male. I am five foot six inches tall and weigh approximately 135 lbs. am in generally excellent health, but not right now. I do not take any medications or supplements regularly, I eat a fairly healthy diet and I do not smoke or use drugs. I drink socially about 3 times a month. I took ill 5 days ago on tuesday evening. Prior to me feeling actually ill, my tonsils were causing me a great deal of pain, it actually woke me up in the middle of the night about 2-3 nights before I felt very ill. Approximately 1 week prior to the night where my tonsil pain woke me up, I had the common cold that was going around and I was not severely effected. On tuesday I went to see a massage therapist at 2 pm and felt fairly good, no complaints. By tuesday at 5 pm had arrived at my work at a gym and was incredibly fatigued and shivering . In my few moments downtime I found myself literally hugging the space heater. From 5-8 I had to work and I am surprised I made it through. When I got home, I checked my temperature and it was 103 degrees F. I had fatigue, lethargy, sore throat tonsillar , general aches and pains in knees and wrists. I believed I had the Flu which is going around the country right now. I rested, mostly lying down and napping for 2 days expecting the flu to pass. I felt extremely weak. I noticed some slight spotting on my tonsils but was too ill to bother to get out the flashlight to investigate further. Once I took the effort to get out a flashlight and investigate my throat I became incredibly certain I had strep throat . I investigated the known symptoms of strep throat and cross referenced with images of strep throat infection online. I met every single criteria for strep throat. I am typically fairly in tune with my body and I could tell this was not a normal illness. This was thursday and my temperature had hit a momentary high of 104.3 degrees F. I do not have health insurance and I live alone with no relatives to assist me. I tried to find places where I could quickly get a strep rapid test and/or throat culture test performed. Nothing was available to me except for a free clinic which has an average wait time of 6 hours. I did not think I could last 6 hours in a clinic. I decided to begin the use of some amoxicillin which I had in my medical kit. I purchased it in mexico and it was never opened and stored in what I would consider highly optimal conditions. I always finish my course of antibiotics and know how dangerous stopping because you feel better can be. The amoxicillin was approximately 1.25 years past its best by date but I called poison control and performed further research and determined that amoxicillin does not become toxic after its expiration date, and only its potency or efficacy can be reduced. I started at approximately noon on thursday taking 500 mg amoxicillin 3 times daily exactly every 8 hours. within 16-24 hours my 104 degree fever had gone down to approximately 100-101. I did not eat at all on wednesday, thusday, and only ate again friday evening. my temperature has now stabilized at around 100 most of the time. I am suffering from diarrhea, which was probably made worse by not eating and only ingesting water. The diarrhea had an oily appearance and contained bubbles, I took the oily nature to possibly be stomach bile and the bubbles to potentially indicated the violence of the intestinal activity.irritation. The diarrhea started before the use of the antibiotics. I continue to rest and push fluids and monitor my temperature. overall it seems improved but I am still feeling very poorly. As I write this right now my temperature is 100.8. This morning has seen a new symptom of some chest tightness, nothing I would describe as painful but enough to raise an eyebrow. I do not know what this could be. additionally there have been 2 times where my tonsil/ back of throat bled. Both times I had almost vomited and I believe the increased pressure from the heaving contraction burst a blood vessel or something of that nature. bleeding lasted approximately 40 seconds each time with maybe a table spoon or so of fresh bright red blood being lost before the bleed clotted. This has only happened when nearly vomiting. I am sorry this is long, but I thought a thorough initial writing would be more helpful to you. Can you advise me?
Fri, 27 Sep 2013
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ENT Specialist 's  Response
Hello Kirk and welcome to HCM,

I am here to help you out on your problems. A long write up is definitely good as it gives us more things to help you out with.

Coming to your problem as such since you are suffering so much let us get straight to the point:

1. You may continue and complete the course of antibiotic which you have started but its always if you had good medication and not expired ones. If you become better in a day or two then its fine or else I would definitely advice you to take a combination of amoxycillin-clavulanate twice daily after food for five days. Your doctor will know about this.

2. You also need a pain killer and an anti pyretic or anti fever medication like paracetamol for proper symptom control.

3. Since you have started bleeding from the tonsil and throat it is most likely that you also have developed a reflux. Thus you need to start an anti reflux tablet like pantoprazole 40 mg twice daily before food for two weeks. Your doctor will know about this too.

4. Take only warm food and fluid and do salt water gargle but do not starve as your body needs strength to recover

wait for four to five days and if the symptoms do not improve or get worse then get a throat swab and get back to me or any ENT doctor with the reports.

Also if the pain is severe, you may ask your doctor for injections for better and faster control of symptoms

take care and get well soon

Dr Sriram Nathan
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Have Cold With Sore Throat. Nothing Found In Throat Culture. Took Amoxicillin. Vomited Blood. Reason?

Hello Kirk and welcome to HCM, I am here to help you out on your problems. A long write up is definitely good as it gives us more things to help you out with. Coming to your problem as such since you are suffering so much let us get straight to the point: 1. You may continue and complete the course of antibiotic which you have started but its always if you had good medication and not expired ones. If you become better in a day or two then its fine or else I would definitely advice you to take a combination of amoxycillin-clavulanate twice daily after food for five days. Your doctor will know about this. 2. You also need a pain killer and an anti pyretic or anti fever medication like paracetamol for proper symptom control. 3. Since you have started bleeding from the tonsil and throat it is most likely that you also have developed a reflux. Thus you need to start an anti reflux tablet like pantoprazole 40 mg twice daily before food for two weeks. Your doctor will know about this too. 4. Take only warm food and fluid and do salt water gargle but do not starve as your body needs strength to recover wait for four to five days and if the symptoms do not improve or get worse then get a throat swab and get back to me or any ENT doctor with the reports. Also if the pain is severe, you may ask your doctor for injections for better and faster control of symptoms take care and get well soon Dr Sriram Nathan