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What are the possible causes of chronic sore throat, swollen glands, pressure in the ear, and sticky eyes?

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Medically reviewed by

iCliniq medical review team

Published At November 1, 2022
Reviewed AtOctober 6, 2023

Patient's Query

Hello doctor,

I have had swollen glands, sore throat, pressure in my ears, sticky eyes, and fatigue for the past 82 days. The blood work looks good. I have tested negative for HIV, thyroid, and STDs. I do not have COVID-19. There are no signs of anemia or significant infection. The Epstein-Barr virus testing shows that I have had a previous infection but no acute infection. I took the tablet Azithyromycin for five days, but I still have the symptoms. Why?

Hello,

Welcome to icliniq.com.

I have read your query.

I am glad to read that all of your tests related to infection came back negative. The opinion of the ENT (ear, nose, and throat) also revealed no significant finding. There is no sign of STD (sexually transmitted disease) or any other infection in the laboratory tests. Please answer the following questions:

  1. Did you undergo any imaging tests?
  2. Any reduction in the severity of symptoms compared to initial episodes?

You have symptoms, but infection is not documented on laboratory tests. By reading your complaints with sexual exposure history hint towards some infection, but all test reports (attachments removed to protect the patient's identity) are negative or normal till now. I suggest continuing the tablet Azithromycin 500 mg once daily for five to seven days since you had improvements in the symptoms after taking medicine. Consult a specialist doctor, discuss with them, and take medications with their consent.

Patient's Query

Thank you doctor for the reply,

I guess that it could be viral pharyngitis. While symptoms have steadily improved over time, I still have ear pressure, sore throat, tender glands, and slight chills from time to time. The ENT performed an endoscopy and did not see anything. Several doctors have examined me, and no signs of rashes, warts, or mouth spots were observed. However, the issue is the length of time and symptoms were severe, and I have mostly been in bed or on the couch.

Hello,

Welcome back to icliniq.com.

I got your point that you have not received any confirmed diagnosis. I cannot add a differential diagnosis because the infection was hinting to me after reading your initial complaints, and I would have also suggested the same tests above. Still, now these laboratory tests come negative also. Do not worry about it. I am confused about the duration of the symptoms. Viral pharyngitis does not stay this long. However, symptoms have improved over time, and I suggest taking the antibiotic mentioned for another week. Do a lukewarm water gargle two to three times a day. If possible, get a CT (computed tomography) scan done for swollen tender glands after visiting an ENT (ear, nose, and throat) doctor.

I guess symptoms will continue to improve also in the upcoming time. I would follow up after another week to assess any further change in the severity of symptoms.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Basuki Nath Bhagat
Dr. Basuki Nath Bhagat

Family Physician

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