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
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
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
Kindly share the links.
Please explain clearly.
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.
