Q. My left tonsil is swollen, and I have a severe post-nasal drip from a month. Please help.

Hello doctor,

I am a 46 year old female, and I am a non-smoker and non-drinker. I received a kidney transplant 16 years ago. I am in a very good health, and I had no bouts of rejection. I eat well and exercise. I just started a new job in another city, so I had to move. Two months back, everyone in the office seemed to be sick, and they had lots of coughing. So, when I noticed a swollen left tonsil approximately a month ago, I was surprised as I had never experienced this in 46 years, but yet with everyone seemingly sick, I was not terribly surprised. I did not feel much discomfort the first week, and I felt like I had a cold. So, I went to a walk-in clinic. The doctor swabbed my throat, but I had no strep infection. So, no antibiotics were given. The doctor told me to gargle with salt water.

Approximately a week later, I woke up in the middle of the night, and my throat was very sore. I also was starting to feel unwell and believed I was starting to get a bad sinus infection. I have had several since my transplant, but not recently within the past year or two. Post-nasal drip has been excessive along with general malaise and extreme fatigue. This has been the sickest I have been since pre-transplant 16 years ago. I went back to the walk-in clinic. The doctor prescribed Clindamycin for 10 days at 300 mg. He also sent me for a throat ultrasound due to enlarged submaxillary glands to see if there was an abscess.

The medication made me sick at first and a bit of facial swelling, but after 2 to 3 days, my body got used to it, and it seemed to start helping. I was very sick overall for about a week and then started to feel back to normal including energy and no more malaise. The sore throat seemed to dissipate. However, my left tonsil was still swollen. I started to experience blood in my phlegm first thing in the morning when I would clear my throat and only in the morning. My ultrasound came back normal.

I finished the 10-day course of antibiotics. My throat started to become sore again, only on the left side. It has been over a month, and it is still swollen. So, I went back to the walk-in clinic, and this time the doctor prescribed Azithromycin 250. Again, I gargled with warm salt water. And I just started the new antibiotics. But, I still do not feel better. I have never had a swollen tonsil in my 46 years nor am I one to deal with a sore throat for any more than a day or two, and I am now going on at least 2.5 weeks, I feel it every time I swallow and yet eating does not bother me. I have ingested more throat lozenges, popsicles, and gargled to no avail. I am becoming frustrated and concerned at the same time. Please help.

Two years ago, I developed vertigo suddenly when on vacation. I had extreme allergy attack with a choking post-nasal drip at night. I never had allergies before. The doctor at that time said it was a bad year for non-allergy sufferers and worse for those with allergies already. I was prescribed nasal steroids.

Hello doctor,

Thank you for replying. That does not sound good. The doctor seemed like it was no big deal, which is why I wanted to check. I have attached a couple of pictures. I do take medication for blood pressure. I take 8 mg of Candesartan for a few years now. I do not have diabetes.

My kidney function is normal for a transplant patient. My creatinine range is 90 to 105. I do not have food restrictions, and I am just not permitted to take sulfa-based drugs or Ibuprofen due to the transplant or any drugs that boost the immune system.

I am lactose intolerant, and I have been for years. I have taken various acid reflux medication over the years. But, I am not taking anything as of late, as it has not been bothering me too much.