Dr. Shyam Kalyan. N
Otolaryngology (E.N.T)
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hi doctor,
I have a recurring sore throat, swollen tonsils, and pain in the neck and sometimes in the ears. I have been prescribed with antibiotics and steroids, which work for me at the moment, but after one or two weeks, it returns. Thank you.
Hi,
Welcome to icliniq.com.
Can you take a picture of the back of the throat showing details of the tonsils and send them to me? Did these problems start after Covid? Thank you.
Patient's Query
Hi doctor,
Thank you for your answer. Yes, this photo is from two weeks ago, I was prescribed with decongestants and Amoxicilin and Ibuprofen 800 mg every eight hours. It did not work, I took it for seven days and it kept getting worse. I went back to the doctor and he prescribed me Clindamicyn and Prednisone, as soon as I started taking these two I began to feel much better, I finished the antibiotic a few days ago and today my neck and throat began to hurt. The tonsils are still not very swollen for now. Thank you.
Hi,
Welcome back to icliniq.com.
So this image (attachment removed to protect the patients identity) taken two weeks back shows highly inflamed tonsils. Probably the infectious agent was not sensitive to Amoxicillin but worked with Clindamycin. 1. Have you had tonsillitis before, also? Because the tonsils are quite swollen, and if the problem is recurrent, we may have to consider surgery. 2. How do you feel now? 3. Do you have a lot of as much pain as what was there two weeks back? 4. Do you have worsening pain while swallowing? 5. Any fever? 6. Any swelling on the side of the neck? If the above is not very problematic, then you have taken a course of a good antibiotic and are feeling better than before. Regarding the pain, try doing some Benzydamine gargles thrice daily along with warm saline water gargling intermittently. Take Tylenol when the pain is bad. I would appreciate it if you could still take a picture and send it. Thank you.
Patient's Query
Hi doctor,
Yes, it had happened to me before after the Covid. This is the third time. But two weeks ago, it was the strongest of all. It had never hit me like this. And also, as I mentioned, after Covid, my ears get clogged, and it feels and sounds like I have liquid or air inside. I do not know. It sounds like clicking when I make any movement, be it swallowing or yawning, and they have prescribed me decongestants for that, and it continues the same. Apart from that, I do not feel as bad as I had two weeks ago, and I have some swelling inside my neck. I get a headache, and I have not had a fever yet. I have been taking Advil for the pain and gargling too. Thank you.
Hi,
Welcome back to icliniq.com.
So the current picture does not show a lot of infection (attachment removed for patient identity protection). If we can regard this as your baseline tonsillar size, it is still somewhat big. We can regard this as grade two to grade three tonsils. After Covid, we see a lot of recurrent tonsillar infections. This could be due to the immunological changes that Covid has done. Regarding your ears, it is possible that there is some tubal blockage along with tonsillitis. The Eustachian tubes connect the back of the nose with the ears. Any infection in the nose and throat can cause such a blockage leading to fluid accumulation inside the ears. This is detected by an otoscopic examination and impedance audiometry, a non-invasive audiological test. Have you done this test? Is there a b or c curve in either of the ears? Thank you.
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Otolaryngology (E.N.T)
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