Breathing issue, bacterial infection

Question #15533

100 days ago

250

Breathing issue, bacterial infection - #15533

Noor

Patient Summary for Medical Consultation Patient: Noor Main Concern: Recurrent throat blockage, chronic sinus issues, and recent white spot on tonsils. 1. History of Present Illness Chronic Issues • I have had tonsils since childhood, never caused major problems before. • Since last winter (1 year ago), I developed: • Chronic sinusitis • Adenoidal inflammation • Occasional night-time breathing difficulty • Dry throat especially during winter nights • In summer (humidity environment), symptoms significantly improved. Recent Episode (Last 2 weeks) • 14 days ago I had a viral infection (common in family/community). • After recovering from viral infection: • My throat still feels dry at night • Breathing feels blocked when lying down • Voice becomes low, I can't speak easily due to nose/throat blockage • Mucus continues production throughout the year • No fever. • No significant pain while swallowing, but slight effort is needed. • Mouth gets dry during sleep (in winter). 2. Tonsils and Pus • Today I noticed: • One small white dot of pus on the tonsil • No large patches • Tonsils are swollen looks red • Breath does not smell so much bad but feels slightly nausea since yesterday • I am feeling slight nausea since yesterday. (I ate fish yesterday and did vomit 3 times may be due to smell of fish or mucus production) 3. Previous Severe Episode • Last year 2024 November I had a very severe throat infection (no antibiotics taken). • I could feel a tear/wound inside the throat, and nose bleeding also occurred. (May be I am the only person in this world who can touch the throat by tongue, so when I touched at that time something teardown and I got slight bleeding from nose too) • Since that illness, I am having repeated: • Sinus congestion • Adenoid swelling • Night breathing difficulty 4. Treatments Tried I have been doing regularly: • Warm saline gargles (salt + turmeric) • Nasal saline rinses (wuzu style) • Steam inhalation • These give temporary relief for 15–20 minutes, but symptoms return at night. 5. Previous Online Doctor Opinion A doctor reviewed my throat picture and said: • Most likely GERD + chronic sinusitis • Not an active infection • Treatment suggested: • Antacids / PPIs • Nasal decongestant spray • Diet precautions • 2-month follow-up 6. Current Questions for Physician I would like your medical guidance on the following: • Considering my 1-year chronic throat + sinus issue, and now fresh small white pustule, which antibiotic is more appropriate? • Cefixime 400 mg once daily • OR Augmentin (Amoxicillin–Clavulanate) lower-dose option • Is this recent white spot a sign of acute bacterial flare-up on top of my chronic condition? • Should I also continue: • Fluticasone nasal spray (once daily) • Daily saline rinse • Could my symptoms still be due to GERD + chronic sinusitis, or is this now mainly a tonsillar infection? • Is surgery (tonsils/adenoids) needed if medical treatment works, or can I manage medically? I created video links embedded in pdf and photos for your evaluation, please allow me to send. Note: "I just had my first episode of watery loose motion a short while ago. I also felt dizzy while offering prayer." (I am allergic to metronedazole group medicines)

Chronic throat condition

300 INR (~3.53 USD)

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Dr. Arsha K Isac

I am a general dentist with 3+ years of working in real-world setups, and lemme say—every single patient teaches me something diff. It’s not just teeth honestly, it’s people… and how they feel walking into the chair. I try really hard to not make it just a “procedure thing.” I explain stuff in plain words—no confusing dental jargon, just straight talk—coz I feel like when ppl *get* what's going on, they feel safer n that makes all the difference. Worked with all ages—like, little kids who need that gentle nudge about brushing, to older folks who come in with long histories and sometimes just need someone to really sit n listen. It’s weirdly rewarding to see someone walk out lighter, not just 'coz their toothache's gone but coz they felt seen during the whole thing. A lot of ppl come in scared or just unsure, and I honestly take that seriously. I keep the vibe calm. Try to read their mood, don’t rush. I always tell myself—every smile’s got a story, even the broken ones. My thing is: comfort first, then precision. I want the outcome to last, not just look good for a week. Not tryna claim perfection or magic solutions—just consistent, clear, hands-on care where patients feel heard. I think dentistry should *fit* the person, not push them into a box. That's kinda been my philosophy from day one. And yeah, maybe sometimes I overexplain or spend a bit too long checking alignment again but hey, if it means someone eats pain-free or finally smiles wide in pics again? Worth it. Every time.

99 days ago

Hello Noor,
Your symptoms most likely come from:
Chronic sinusitis plus adenoid swelling
Post-viral irritation
Possible GERD
A mild flare of tonsil inflammation
The single white spot does NOT necessarily mean a serious bacterial infection.
🛑Antibiotics?
You may not need antibiotics right now unless symptoms worsen (fever, more white spots, severe throat pain).
Augmentin is usually better for sinus/tonsil infections, but it can worsen your current loose motion.
Cefixime is milder but not first choice for tonsillitis.
Should decide after examining.
🛑Continue:
Fluticasone nasal spray daily
Saline rinse 1–2 times/day
Steam inhalation
Warm salt-water gargles
🛑GERD could still be contributing
Night symptoms, dryness, and post-nasal drip fit GERD.
A PPI trial may help discuss with your concerned doctor.
🛑Loose motion + dizziness:
Drink ORS immediately.
Seek care if dizziness continues or diarrhea worsens.
🛑Surgery not needed now
Only if symptoms remain after 3 months of correct medical treatment.
Okay
I trust this answers your concern
Feel free to talk
Thank you

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Dr. Bharat Joshi

I’m a periodontist and academician with a strong clinical and teaching background. Over the last 4 years and 8 months, I’ve been actively involved in dental education, guiding students at multiple levels including dental hygienist, BDS, and MDS programs. Currently, I serve as a Reader at MMCDSR in Ambala, Haryana—a role that allows me to merge my academic passion with hands-on experience. Clinically, I’ve been practicing dentistry for the past 12 years. From routine procedures like scaling and root planing to more advanced cases involving grafts, biopsies, and implant surgeries. Honestly, I still find joy in doing a simple RCT when it’s needed. It’s not just about the procedure but making sure the patient feels comfortable and safe. Academically, I have 26 research publications to my credit. I’m on the editorial boards of the Archives of Dental Research and Journal of Dental Research and Oral Health, and I’ve spent a lot of time reviewing manuscripts—from case reports to meta-analyses and even book reviews. I was honored to receive the “Best Editor” award by Innovative Publications, and Athena Publications recognized me as an “excellent reviewer,” which honestly came as a bit of a surprise! In 2025, I had the opportunity to present a guest lecture in Italy on traumatic oral lesions. Sharing my work and learning from peers globally has been incredibly fulfilling. Outside academics and clinics, I’ve also worked in the pharmaceutical sector as a Drug Safety Associate for about 3 years, focusing on pharmacovigilance. That role really sharpened my attention to detail and deepened my understanding of drug interactions and adverse effects. My goal is to keep learning, and give every patient and student my absolute best.

99 days ago

Hello dear
See after careful evaluation it seems you are having combination of nasal and gastric issues.
You have already taken best medication and it seems reoccurrence due to incomplete infection removal or decreased resistance.
Iam suggesting some tests.
Please get them done for confirmation
Antibiotic sensibility testing
Viral culture
Cbc
Esr
Fungal culture
Allergy test( blood allergy)
Skin prick test
Lung USG if recommended by ent surgeon
I request you to please share result with ent surgeon/ pulmonologist in person for better clarity
Please donot start any medication without consulting the concerned physician
Hopefully you recover soon
Regards

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Dr. Prasannajeet Singh Shekhawat

I am a 2023 batch passout and working as a general physician right now, based in Hanumangarh, Rajasthan. Still kinda new in the bigger picture maybe, but honestly—every single day in this line teaches you more than textbooks ever could. I’ve had the chance to work under some pretty respected doctors during and after my graduation, not just for the clinical part but also to see how they handle people, real people, in pain, in panic, and sometimes just confused about their own health. General medicine covers a lot, right? Like from the smallest complaints to those random, vague symptoms that no one really understands at first—those are kinda my zone now. I don’t really rush to label things, I try to spend time actually listening. Feels weird to say it but ya, I do take that part seriously. Some patients just need someone to hear the whole story instead of jumping to prescription pads after 30 seconds. Right now, my practice includes everything from managing common infections, blood pressure issues, sugar problems to more layered cases where symptoms overlap and you gotta just... piece things together. It's not glamorous all the time, but it's real. I’ve handled a bunch of seasonal disease waves too, like dengue surges and viral fevers that hit rural belts hard—Hanumangarh doesn’t get much spotlight but there’s plenty happening out here. Also, I do rely on basics—thorough history, solid clinical exam and yeah when needed, investigations. But not over-prescribing things just cz they’re there. One thing I picked up from the senior consultants I worked with—they used to say “don’t chase labs, chase the patient’s story”... stuck with me till now. Anyway, still learning every single day tbh. But I like that. Keeps me grounded and kind of obsessed with trying to get better.

99 days ago

Hello Noor
By going through your history and evaluation of your health status I must say that nothing to Worry you will get fine soon. I am suggesting you following treatment as follows -
Rx -
Cap Pantop dsr - daily before breakfast
Tab Amoxicillin 625 mg - once a day for 7 days
Mouth gargle - Chlorhexidine - 2 time a day
Tab Montac lc - at night for 7 days
Tab Acelofenac+ pcm - one at morning one at night for 7 days
Nasal drop - Xylometazoline -2-2 drops for 7 days
Take these following medicine and avoid intake of cold things and wear mask when goes out .
Thank you

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Dr. Nirav Jain

I am a qualified medical doctor with MBBS and DNB Diploma in Family Medicine from NBEMS, and my work has always been centered on treating patients in a complete, not just symptom based way. During my DNB training I rotated through almost every core department—Internal medicine, Pediatrics, Obstetrics & Gynecology, Surgery, Orthopedics, ENT, Dermatology, Psychiatry, Emergency medicine. That mix gave me the skill to manage acute illness, long term disease and preventive care together, something I find very important in family practice. In psychiatry I worked closely with patients who struggled with depression, anxiety, stress related problems, insomnia or substance use. I learned not just about medication but also about simple psychotherapy tools, psycho education and how to talk openly without judgement. I still use that exp in family medicine, specially when chronic disease patients also face mental health issues. My time in General surgery included assisting in minor and major procedures, managing wounds, abscess, sutures and emergencies. While I am not a surgeon, this gave me confidence to recognize surgical cases early, provide first line care and refer fast when needed, which makes a big difference in online or OPD settings. Now I work as a consultant in General medicine and Family practice, with focus on both in-person and online consultation. I treat conditions like fever, infections, gastrointestinal complaints, respiratory illness, and also manage diabetes, hypertension, thyroid disorders, and lifestyle related chronic diseases. I see women for PCOS, contraception counseling, menstrual health, and children for common pediatric issues. I also dedicate time to preventive health, lifestyle counseling and diet-sleep-exercise advice, since these small changes affect long term wellness more than we often realize. My key skills include holistic diagnosis, evidence based treatment, chronic disease management, mental health support, preventive medicine and telemedicine communiation. At the center of all this is one thing—patients should feel heard, safe, and guided with care that is both professional and personal.

99 days ago

Hello Noor, thank you for sharing your concern. According to what you explained you probably have a post nasal drip due to your sinusitis and adenoid issues. The single white dot on your tonsil is usually a small tonsillar exudate from irritation or mild bacterial superinfection after a viral infection. This does NOT always mean a severe tonsillitis. This looks like a flare-up over a chronic problem, not a new major infection. Here are my answers to your questions-
1. Augmentin is better and you should take it as you might have superinfection. And yes, the spot is an acute flare up on your chronic condition. Continue Fluticasone nasal spray and daily saline rinse. Your symptoms might also be due to GERD as well. I’ll prescribe you a medicine for that for now. Confirmation of GERD will be done by a physical examination by a doctor. Taking this medicine will be harmless and do only benefit. So, no issues. No surgery (tonsil/adenoid) is needed unless: 4–5 severe infections per year.Persistent nasal blockage not responding to treatment. Sleep apnea/snoring with choking. Recurrent pus on tonsils with fever. Sinus symptoms >3–4 months despite regular sprays + saline rinse. Your case is manageable medically. I am also adding medicines for your loose stool in the prescription below.
2. Here is the final prescription -
- Tab. Augmentin 625ng twice daily × 5 days.
- Cap. Pantoprazole 40mg before breakfast × 14 days (GERD)
- Continue Fluticasone Nasal Spray
- Tab. Cetirizine 10mg at night × 5 days (if nose is very blocked)
- Tab. Lactic Acid Bacillus twice a day × 5 days
- ORS.
Feel free to reach out again.
Regards,
Dr. Nirav Jain
MBBS, DNB D.Fam.Med

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Dr. Nirav Jain

99 days ago

Kindly share the links.

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Dr. Shayeque Reza

I completed my medical degree in 2023, but honestly, my journey in healthcare started way before that. Since 2018, I’ve been actively involved in clinical practice—getting hands-on exposure across multiple departments like ENT, pediatrics, dermatology, ophthalmology, medicine, and emergency care. One of the most intense and defining phases of my training was working at a District Government Hospital for a full year during the COVID pandemic. It was chaotic, unpredictable, and exhausting—but it also grounded me in real-world medicine like no textbook ever could. Over time, I’ve worked in both OPD and IPD setups, handling everything from mild viral fevers to more stubborn, long-term conditions. These day-to-day experiences really built my base and taught me how to stay calm when things get hectic—and how to adjust fast when plans don’t go as expected. What I’ve learned most is that care isn't only about writing the right medicine. It’s about being fully there, listening properly, and making sure the person feels seen—not just treated. Alongside clinical work, I’ve also been exposed to preventive health, health education, and community outreach. These areas really matter to me because I believe real impact begins outside the hospital, with awareness and early intervention. My approach is always centered around clarity, empathy, and clinical logic—I like to make sure every patient knows exactly what’s going on and why we’re doing what we’re doing. I’ve always felt a pull towards general medicine and internal care, and honestly, I’m still learning every single day—each patient brings a new lesson. Medicine never really sits still, it keeps shifting, and I try to shift with it. Not just in terms of what I know, but also in how I listen and respond. For me, it’s always been about giving real care. Genuine, respectful, and the kind that actually helps a person heal—inside and out.

99 days ago

Please explain clearly.

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Dr. Aarav Deshmukh

I am a general physician with 8 years of practice, mostly in urban clinics and semi-rural setups. I began working right after MBBS in a govt hospital in Kerala, and wow — first few months were chaotic, not gonna lie. Since then, I’ve seen 1000s of patients with all kinds of cases — fevers, uncontrolled diabetes, asthma, infections, you name it. I usually work with working-class patients, and that changed how I treat — people don’t always have time or money for fancy tests, so I focus on smart clinical diagnosis and practical treatment. Over time, I’ve developed an interest in preventive care — like helping young adults with early metabolic issues. I also counsel a lot on diet, sleep, and stress — more than half the problems start there anyway. I did a certification in evidence-based practice last year, and I keep learning stuff online. I’m not perfect (nobody is), but I care. I show up, I listen, I adjust when I’m wrong. Every patient needs something slightly different. That’s what keeps this work alive for me.

98 days ago

Given your symptoms, it seems like a complex interplay of chronic sinusitis, possible GERD, and now potentially a bacterial infection affecting your tonsils. The appearance of a small white spot on your tonsil could indicate a bacterial superinfection, especially if you haven’t had significant pain or fever, which often accompany more severe bacterial infections. However, the persistent issues with sinus congestion, night-time breathing difficulties, and dry throat suggest that underlying sinusitis and possibly GERD are significant contributors to your ongoing discomfort.
Considering antibiotics, Augmentin (Amoxicillin-Clavulanate) may be a more appropriate choice over Cefixime, especially when targeting both typical respiratory pathogens and specific anaerobes associated with chronic sinusitis and tonsil infections. However, it is crucial to consult a local physician for a prescription, as they can assess your clinical picture more thoroughly and confirm if antibiotics are warranted.
Continuing the fluticasone nasal spray and daily saline rinses can help manage sinus inflammation and maintain nasal hygiene. These can provide some relief, particularly if GERD and chronic sinusitis are contributing factors. Given the chronic, recurrent nature of your symptoms, addressing lifestyle factors, such as diet modifications to reduce GERD symptoms, may be beneficial as well.
Given your recent episode of dizziness and watery loose motions, it’s essential to be cautious. Ensure you stay hydrated and monitor the intensity and frequency of these symptoms. If they persist or worsen, seek immediate medical attention, as these could signify complications or new developments. Surgery for tonsils or adenoids is usually considered when there is failure of medical management or significant structural issues causing persistent symptoms. Given your current situation, consulting with an otolaryngologist (ENT specialist) might provide a more comprehensive plan tailored to your ongoing needs. As for the video and photo assessments, a local in-person examination would be more beneficial to accurately guide your treatment plan.

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Breathing issue, bacterial infection - #15533

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