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Q. I am experiencing throat pain that radiates to my ears. What should I do?

Answered by
Dr. Shyam Kalyan. N
and medically reviewed by Dr. Sneha Kannan
This is a premium question & answer published on Apr 01, 2020 and last reviewed on: Mar 23, 2021

Hi doctor,

It has been three weeks that I am experiencing front neck pain. First two weeks, it is just the right side that is painful, and the pain is just manageable. On the third week (this week), the pain worsens, that I have to take a pain reliever. The entire front of my neck is painful, and I can feel swollen lymph nodes already. The pain radiates to my ears, so it is painful to swallow. I also experience dry cough only at night. I took Paracetamol (Neozep). Then the pain stops but recurs after 6 hours. In the last two days, my body temperature increased. The highest is 37.6 Celcius. But it will be lowered when I take Paracetamol. I take Paracetamol (Tylenol) every 4 hours and consumed five tablets already. The pain subsides but still recurs. I try to compare what I am feeling with COVID-19 symptoms. But I only scored three based on specified symptoms of DOH.

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#

Hello,

Welcome to icliniq.com.

You need an antibiotic. Please take Amoxicillin and Clavulanic acid (Augmentin) 625 mg thrice daily with meals for five days. Take Chymoral Forte (Trypsin Chymotrypsin) tablet before meals thrice daily for three days. Take Montelukast (Singulair) 10 mg, Levocetirizine (Xyzal) 5 mg combination once daily in the evenings daily for seven days. Eat and drink a lot of warm stuff. Drink plenty of warm fluids. Continue Tylenol (Acetaminophen) as you are doing now. When the antibiotic starts acting, the infection, fever, pain, and swelling will subside. Do text us whenever you want.

Thank you doctor,

Is it okay for me to continue breastfeeding my baby while I am taking the medications?

#

Hello,

Welcome back to icliniq.com.

Yes, you can continue breastfeeding avoid Chymorral Forte while breastfeeding. Take other medicines for the duration I told you. With Montelukast and Levocetirizine, your baby may have some sedation, but that is ok.

Thank you doctor,

I will just take two medicines because Chymoral Forte is not advisable for breastfeeding mom? And Chymoral Forte is not available in any pharmacy here. Is there no replacement for Chymoral Forte?

#

Hello,

Welcome back to icliniq.com.

Search Amvilab proteolytic enzymes (Trypsin and Chymotrypsin). Take the first two medicines. If you can stop breastfeeding for four days, then take Trypsin Chymotrypsin for the first two days.

Thank you doctor,

It is really difficult to stop my baby from breastfeeding, doctor because my husband cannot really stop her from crying. She is 18 months old already. Is it alright if I will just breastfeed her hours after I took Trypsin and Chymotrypsin? May I also know the dosage and when it is taken.

#

Hello,

Welcome back to icliniq.com.

Get the Trypsin Chymotrypsin and do not start it for now. Try other medications for few days, say two, and then we shall review. Buy the tablet I told you and, take a picture and show me the dosages. I will guide you.

Thank you doctor,

There is no Trypsin Chymotrypsin equivalent where I live. I just bought Advil (Ibuprofen) as an anti-inflammatory medication. I already started taking the antibiotic yesterday. I consumed five already, but the pain still recurs.

#

Hello,

Welcome back to icliniq.com.

So you are taking Advil and Tylenol, right? In what dosage are you taking the two, and how frequent? What antibiotics have you taken till now, and what dosage? Are antibiotic dosage the same as what I told you?

Thank you doctor,

I take the antibiotic as you prescribed. Tylenol is out of stock. The pharmacist recommended Advil instead. I took Advil every time the pain recurs at six hours intervals.

#

Hello,

Welcome back to icliniq.com.

What dosage of Ibuprofen does Advil have?

Thank you doctor,

The dosage is 200 mg, doctor.

#

Hello,

Welcome back to icliniq.com.

Wait for a while. You need to complete the course of antibiotics, which means five days before we see improvement.

Thank you doctor,

Okay, doctor. I will update you on my progress, doctor. Thank you so much.

#

Hello,

Welcome back to icliniq.com.

Yes, if there is any worsening, please revert to me. Take plenty of warm water and steam if possible.

Thank you doctor,

My husband is asking if it is okay to nebulize me?

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Hello,

Welcome back to icliniq.com.

Nebulisation will help if you have wheezing and breathing troubles. What medicine are you planning for?

Thank you doctor,

I do not have trouble breathing, just an occasional cough. We have Salbutamol (Albuterol) here, doctor.

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Hello,

Welcome back to icliniq.com.

Do not miss out the medications.

Thank you doctor,

My neck pain is gone, but the pain is now concentrated on my tooth. It is really very painful, and I have a fever of 38.7 degrees Celcius.

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Hello,

Welcome back to icliniq.com.

Are there the neck nodes still? What about the cough? Will you be able to access a dentist if needed? Which tooth is paining? Can you touch it with your finger and take a picture and send it?

Thank you doctor,

There are no available dentists as of the moment due to COVID-19. I only have a cough when my body temperature increases, usually every 4 hours. The pain is relieved by Advil for four hours, then it recurs, followed by fever.

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Hello,

Welcome back to icliniq.com.

If there is an infection in the tooth and that is spreading in spite of the antibiotics, you will need intravenous antibiotics at a hospital.

Thank you doctor,

The one that has a bracket is the painful one. I wore braces before, and the bracket was not taken by my dentist and was hard to remove. But prior to instilling a bracket, it has already a little hole, but the dentist covered it telling me it will not give me trouble.

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Hello,

Welcome back to icliniq.com.

What about the neck nodes? Are they still there?

Thank you doctor,

The nodes are gone, but there are new nodes at my lower left jaw. We are discouraged from going to the hospital due to the increasing COVID-19 cases. If an illness can be cured at home, we have to stay at home. I also experience the same tooth pain in the past before my root canal. I was given by my dentist an oral antibiotic that was three years ago. Sadly, my dentist is out of reach at this time. So far, I am relieved with Ibuprofen (Advil). But the pain recurs after four hours. Is it okay to take Advil 200 mg every four hours?

#

Hello,

Welcome back to icliniq.com.

You can take Advil, but the same will go into your baby's blood also as you are lactating. How much is the pain level without Advil? Is there any discharge or sensitivity in the tooth? Does your finger show the tooth (attachment removed to protect the patient's identity) in the lower jaw left side, which previously was attended to by the dentist?

Thank you doctor,

The pain is excruciating. It causes my temperature to rise to 38.8 degrees Celcius. There are no discharges. My tooth looks normal. However, the root is really paining. It was another tooth treated by my dentist. It was at the right. So, will I stop taking Advil?

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Hello,

Welcome back to icliniq.com.

I strongly feel you should go to emergency, get some intravenous antibiotics and see a duty dental surgeon or ENT (ear, nose, and throat) surgeon, and do something. I can suggest a stronger antibiotic try Clindamycin (Evoclin) 600 mg one tablet twice daily for five days. Take Chymoral Forte thrice daily. Take paracetamol preferably and do warm saline rinses of the mouth multiple times daily.

Thank you doctor,

There is no Chymoral Forte here. But I will finish first the first antibiotic you gave me? It is my 4th day taking it.

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Hello,

Welcome back to icliniq.com.

You finish the first antibiotic. I found a substitute for Chymoral Forte, Amvilab proteolytic enzyme. It is not that the same as Chymotrypsin Bromelain Trypsin.

Thank you doctor,

I tried searching but what came out is Coumadin Sodium 2.5 mg tablet. This is equivalent to Chymotrypsin Bromelain Trypsin.

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Hello,

Welcome back to icliniq.com.

Do not buy Coumadin Sodium. If you are not getting anything equivalent to Chymotrypsin, then leave it. I must again say and insist that you should check if it is possible for you to go to emergency and get intravenous antibiotics and get your oral cavity examined.

Thank you doctor,

I will update you on any improvement.

#

Hello,

Welcome back to icliniq.com. Thanks for the positive feedback. I really hope you get better soon.


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