NEUROLOGY EXPERT FORUM
Chronic Sinusitis?

Chronic Sinusitis?


  I have been suffering from sinusitis for several months now (approx 6). In April 1998, My family practicioner subscribed amoxicillin which I took for two weeks.  This was ineffective.  After the amoxicillin, he prescribed Biaxin which I took for two weeks.  This was also ineffective.  He then referred me to an allergist for skin testing.  I was found to have no allergies.  The allergist prescribed Augmentin for two weeks.  After two weeks of Augmentin, my white blood cell count was still elevated and I still had symptoms.  My allergist referred me to an ENT.  The ENT obtained a limited CT Scan  which was almost normal.  He does not think surgery is needed.  He prescribed Dicloxicillin for 20 days and 5 days of Bactroban ointment (2% mupirocin).  At the end of the 20 days, my white count was normal, but I still have mild sinusitis symptoms, e.g., sinus congestion, headaches, uncomfortable throat (scratchy) and fatigue.  My throat is always red.
  In april, my family practicioner had also prescribed Claritin-D for symptoms.  The allergist prescribed Duratuss for 60 days in hopes of draining my sinuses (he did not have a CT Scan at that time).  The ENT suggested that I take Sudafed.  Each of these medications contains psuedoephedrine.
  Where do I go from here?  I read that psuedoephedrine is an ephedra alkaloid which is addictive, thus, it has withdrawal symptoms associated with it.  Is it possible that after such a long time on this medication that I became addicted to it and am now experiencing withdrawal? Or, do I need endoscopic surgery despite the somewhat normal CT Scan.  After each coarse of antibiotics, I become very fatigued.  Does this indicate return of the infection?
  Any information you can provide will be greatly appreciated.
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Dear David,
The questions you are asking are quite valid, but they are a bit beyond what the typical neurologist or neurosurgeon normally treats.  Generally speaking, it sounds as if the physicians are treating you for a sinus infection and this has been variably helpful.  The Claritin is a newer kind of antihistamine that is not supposed to make you drowsy.  You reported that the CT was normal, so it is doubtful a surgeon would need to drain the sinuses.  
In any event, we are not the experts on this particular subject.  Your best bet is to return to your ENT physician for some better answers.  If he
cannot give them to you, then a second opinion to another ENT physician may be wise.
Good luck.







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