Strange throat infection

Hello Dr.,

About 6 weeks ago, I developed a bit of swelling in the left side of my throat. Saliva would not go down smoothly down that side.  (swallowing food is not a problem at this point).  I found it odd, so I visited the doctor.  He said that there appeared to be a virus (throat seemed a bit inflammed) but nothing to be concerned about.

After a month of symptoms I was sent to an ENT.  She had me scoped, and said that indeed my throat seemed swollen and that there was a lot of mucous in my throat.  Also, the lymph tissue at the back of my throat was quite swollen (and continues to be) It seemed not to  concern her - she indicated it could be allergies or a viral infection, or perhaps even acid reflux.

Well, I was put on a PPI and it has had no results (2 weeks now).  I wasn't expecting much because I have never had reactions to food and I don't really get heartburn.  Also, I am not really allergic to anything.  So it has me concerned about a persistent viral infection.

It recently occurred to me that maybe 10 days before my symptoms began, I had a one night stand with a girl I didn't know, whom I gave oral sex to.  As I have had my throat swabbed for everything bacterial, I knew it couldn't be that.  It had me wondering if an HPV infection could be responsible.  Again, my symptoms started as a slight swelling and difficulty swallowing saliva on the left side, to a gradual general swelling of the throat with lots of mucous.  There has never been pain. The lymph tissue at the back of my throat has been swollen throughout this time.  This has gone on for more than 2 months.

So my questions:
1.  Do you have any thoughts as to what this could be?
2.  Does HPV ever cause an immune response such as this?  (and if so, how long does it take?)
3.  Could continued stress cause this type of problem? (I've been quite anxious)
4.  Since a scope revealed nothing and the symptoms continue, would you recommend any further diagnostic procedures?

[Vivek V Gurudutt, MD]

Any number of viruses associated with upper respiratory infections could lead to similar symptoms.  Continued post nasal drip, allergies, and reflux (you don't need to feel heartburn to have "silent" reflux) are other possibilities that your physicians are probably exploring.  Your concerns about HPV are important.  HPV is often asymptomatic and manifests as wart-like lesions.  There is an association between oropharyngeal cancer (tonsil, base of tongue, etc) and HPV.  The time course for symptoms in the oropharynx is not well established and could manifest weeks to years after exposure.  The risk of infection and cancer is higher in those with increased sexual encounters (oral or otherwise).  The bigger issue is getting yourself checked out for sexually transmitted diseases.  There are bacteria that can be tough to culture.  Ruling out infections by gonorrhea, syphilis, and chlamydia are important.  Furthermore, ruling out viruses such as HIV would be especially important. Best wishes.