Q. How to deal with recurrent throat infections with nodules despite taking medications?

Answered by
Dr. Vinay. S. Bhat
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Jan 10, 2023

Hi doctor,

I have recurrent throat infections with nodules. I am a vocal artist aged 38 years. I tend to get recurrent cold infections followed by throat infections which get aggravated with speaking. The episode usually begins with sneezing and irritation of the nose and then later develops into painful nodules in the throat area. Antibiotics do work, but of late, they do not work.



Welcome to

I would like to know a few more symptoms of your condition.

1. Do you get severe throat pain, nose block, and cough during each attack of infection?

2. How long each attack of infection used to stay?

3. Do you used to be completely normal after treatment for each attack of infection?

Also, send me a photo of your throat if possible (with your mouth wide open and tongue protruding).

Hi doctor,

Thank you for the reply,

Yes it is severe, unbearable at times and paining more while talking or eating. Each attack prevails for a week and used to get better with tablet Azee After each attack I used to be normal but this time it has not worked. Already 10 Azee tablets were consumed as of date. I have attached the pictures.



Welcome back to

Your symptoms and photographs (attachment removed to protect the patient's identity) of the throat is suggestive of recurrent upper respiratory tract infections.

Upper respiratory tract infections usually include rhinitis (nose block, sneezing, and excessive mucous production) pharyngitis, and tonsillitis. Sometimes associated with cough mostly productive cough to start with.

The most common cause for recurrent upper respiratory tract infection is viral but in these cases, they come occasionally (two to three times a year).

It may be due to chronic tonsillitis also but in that case, you will not have much of nose symptoms.

Reddish nodules in the pharynx are due to repeated inflammation (they are enlarged pharyngeal lymphatic tissue) they are not really significant and are expected to repeat pharyngitis.

We need to identify the cause for recurrence in your case. The following are the possibilities

1. For resistant bacterial infections of the tonsil and pharynx, you need to get a throat swab to identify the organism and treatment can be planned as per the throat swab culture and sensitivity report.

2. Acute exacerbation of chronic rhinosinusitis can lead to repeated attacks of respiratory tract infections, you need to get an endoscopy of your nose and a CT (computed tomography) scan of the nose and sinuses.

3. Sometimes nose allergy can lead to repeated infections and a course of allergy medicines may give us a conclusion.

4. There are cases where acute exacerbations of chronic tonsillitis present with cold and cough. Tonsillectomy may have a role but I need to see the throat picture during an acute attack of throat pain to confirm the diagnosis

Other uncommon causes include acid reflux disorders and vitamin D deficiency.

So it is a complex process to identify the cause of recurrent upper respiratory tract infection. At first, we give empirical therapy with a good antibiotic such as Amoxiclav with anti-allergy and anti-acid reflux medications. Additionally, depending on vitamin D levels we may include vitamin D supplements in treatment. Depending on the response we decode other investigations and tests.

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