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nic14120 posted:
Hello!! I am seeking your advice to confirm what I have been told from here and there...I value your knowledge and experience, and from past posts to you!!
Last Monday, 9 days ago, I came down with a horrible sore throat and a fever. I went to a new dr and he looked at my throat and felt my neck and said it was viral parynghtis (spelling?) told me to control with motrin but it has to run it's course. I went from the sore throat, to still running a fever off and on, to ear aches, loosing my voice (slowly coming back from last Wed), and as of Sunday I felt feverish (99. so I went to the imm care. Thurs of last week until Sun am I was having a deep cough producing green phlegm. The imm care did a strep test and it was negative, said I sounded fine, and ears were fine. THey labeled it as tonsilitis, I asked if I had that, they said well, no...but because your still not bettter, and feeling feverish again, it's probably bacterial and gave me an antibiotic. I was not jumping to take them, since I had taken antibiotics 5x before in the last 18 months, and didn't want to further compromise my immune system...so I took motirn. I have not felt feverish since Sunday, but I still have a lingering cough, a post nasal drip during the day sporatically, and especially difficult at night, I feel like it's chocking me. I do have some difficulty swallowing on the right side of my throat, but I figured that was from this constant coughing and the PND (which I have never had before)

I am worried as this is the longest I have ever been sick. Is it possible that a viral infection could last 9 + days? Is there a period in which I should see the dr yet again if it's not completely resolved? Any adv to help with the PND? My sister thinks I should see the dr again, but I am fearful of them saying the same thing and giving me meds that I don't know will help if it is viral.

THank you
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Rod Moser, PA, PhD responded:
Viral infections typically last about a week, but it is possible to get back-to-back viral infections. In other words, you catch another before the first one left. Viruses do set the stage for a secondary bacterial infection, often in the bronchials or sinuses. Sinus infections can be one cause for your post-nasal drainage and sore throat, which can also trigger a reactive cough.

As these lingering or worsening infections approach the ten-day point, I start being concerned about a bacterial component, so perhaps you should reconsider that antibiotic (What did the doctor prescribe?) if you are not improving.
 
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nic14120 replied to Rod Moser, PA, PhD's response:
Thank you:) they prescribed clindaymcin. I do feel better each day, is it ok for me to wait it out a few more days? Is it possible for a dr to run further tests or bloodwork, to confirm its bacteria (prior to the course of antibiotics?)
 
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Rod Moser, PA, PhD replied to nic14120's response:
Clindamycin is an unusual choice.

Yes, if you are feeling better each day, you are heading in the right direction. It is definitely okay not to take an antibiotic at this point.

Other than a CBC (which is really non-specific) and a blood and throat culture (that takes 2-3 days), there is really no good tests to confirm bacteria or not. Most medical providers make a clinical judgement - a decision based on history and physical examination findings.
 
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nic14120 replied to Rod Moser, PA, PhD's response:
The immediate care dr previously prescribed Biaxin, but I neglected to share thay i have a heart arrythmia. When i read the reviews on it, I went back to request a new one. I do have a follow-up question. During the day, since yesterday, I feel good. No cold symptoma other than an occasional deep cough. I feel like my body is trying to expell mucous. Every night it seems when i lay down, last night as well, that saliva or post nasal drip, will collect in the back of my throat, and it causes a gagging reflex, and creates a coughing attack, making it a struggle to fall asleep. Is it possible for me to have a drip, only at night like this?
 
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Rod Moser, PA, PhD replied to nic14120's response:
Gravity....

When you lie down, the sinuses can drain more freely.

Don't take a decongestant or Mucinex at night, if you are doing this.


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