Chronic Sore Throat for One year

[naveea]

Hi

I have had sore throat for  over a year now...am 27 year..smoker

It started last year around april 2009, had a sore throat after unprotected oral and protected vaginal exposure..took antibiotics..it went away...then came back after a month...started recurring every 3 weeks,,,after which it became constant

I had tried loads of antibiotics ,dint help ..quit smoking..dint help either

So 6 months back had my tonsils removed, corrected my deviated septum and cleared my sinuses

The surgery dint help,it just made my condition worse..I have tested negative for Sypllis,Heb-B and HIV(tested on 26th may 2010,6 weeks from my protected vaginal and protected oral exposure)

Doc put me on antidepressants..Dint help either...

Endoscopic biopsy of my stomach was +ve for H.Pylori.. was again put on antibiotics and PPI's...dint help either

My Random Blood sugar was weired,,,once it was 50...next time it was 133,...last time i checked it was 114..Doc said not to worry

I now have sore chest,tongue and throat ,achy armpits,cobblestone throat,postnasal drip,painful lymph nodes(below ears),feverish(98F) ,Upper arm and upper back pain,stiff neck

Sinus rinse and nasal spray has helped to some extent..so am on this for 1 month....have had 25% reduction in pain

I get up in the morning with no sore throat or any other symptoms,...It just gets worse as the day progresses

Sore throat subsides for 15 mintues after i eat,,,then it comes back...feel nausea..

Latest CBC

TEST                        RESULT  NORMAL
WBC                         6900      4500-10500            
NEUTROPHILS            66          50-65 %                 (Elevated)
EOSINOPHILS             06           3-5 %                    (Elevated)    
LYMPHOCYTES           27           25-35                    
PLATLETS                   1.8         1.5-4.0                     ( Has gone down from my previous tests)

Urine had traces of RBC.. 2-4

Any Suggestions would be helpful..Am from india...My doc thinks its all in my head,,,,well i dont think so

[Ahmed34]

naveea,

I think the latest reply from the doctor here makes a lot of sense. There are a lot of differences in the kinds of diseases and illnesses and their prevalence in the Indian Subcontinent vs the US and the Europe. I thought the links are a good read. I don't quite understand how does Indian physicians migrating to the US relate to your condition here or the standard of medical care in India, but I have never come across a situation where I felt as if I should be in the US to get a good medical advice from a qualified doctor!

I personally think research studies are more for the benefit of patients, even though, somehow, it seems they are accessible so easily to patients. And I don't believe there is any disadvantage that you are seeking medical help in India, as is evident from the proportion of US and European people seeking out information on sites like this.

Londres70,

What do you mean when you said you know 'a lot' of Indian physician go to the USA to practice? And I think the number of doctors moving out to the US is minimal compared to those who stay back and work in India itself.

[Londres70]

At this point I think you should reconsult your IM(Internal Medicine) Physician and if he is not providing proper guidance/recommedation and/or your problems are not being investigated or resolved, I would seek the opinion of another IM.  You need someone IN PERSON who can sort all of this out; not reading research studies that you are probably not going to have a clue how that relates to you.

That is my recommendations at this point.  

I am not a physician, but I am an RN (Registered Nurse) with a Master's Degree who has worked with many different kinds of physicians in an Inpatient (hospital) and outpatient settings for the last 12 years.  (worked in the USA and in Europe).   I am not knowledgeable about the medical care in India.  I do know ALOT of Indian physicians go to the USA to practice.      

[naveea]

Thanks for replying doc

Its the lymph nodes which i am worried about most, because Pharyngitis only causes painful lymph node in neck,but i also achy armpits where i believe lymph nodes are also present

[naveea]

Thank you both ,

My MD is an Internist.. and he is from manipal hospital, bangalore

Well only condition i had from childhood was chronic sinusitis,only in winters...but never had a sore throat

The rash was all over the palm,on fingers and sides of my palm..I still have scars which i can see in dim light

Regarding the RA factor which came as positve,my doc says its false postive ....

[OHNS2010]

Hi,

I think the forum is being dragged into different aspects clinging to a particular set of symptoms or tests as you go on mentioning each time you put a post. All these are speculations, but only after a thorough examination your problem can be diagnosed and solved amicably.

“CHRONIC PHARYNGITIS” is a broad terminology it might be because of various reasons. It might be secondary to DYSPEPSIA termed as LARYNGO PHARYNGEAL REFLUX. You are very apprehensive about your condition. The painful nodes are probably because of acute exacerbation of chronic pharyngitis.

There are fewer chances of you getting infectious disease after a protective performance. Infectious mononucleosis is less common in India compared to that of US; your physician would have definitely picked it up when the tests were done.

• The overall percentage of EBV specific heterophile (Paul-Bunnel) antibody positivity was found to be 11.1% (194/1741). The average Paul-Bunnel antibody positivity between 1986 to 1990 was 20.5% which declined drastically to 5.7% during 1991-2000. Males comprised of 55.2% of the serologically proven IM cases.
(http://www.ncbi.nlm.nih.gov/pubmed/14979379)

• In a research conducted in 2002, it was found that about 95 percent of adults of the age group 35-40 years had been infected by mononucleosis in the United States. When Epstein-Barr Virus (EBV) infection occurs during teenage or young adulthood, in 35 to 50 percent cases it causes infectious mononucleosis.
(http://www.tarunaoils.com/articles/mononucleosis-causes-mononucleosis-statistics.asp)

Rheumatoid factor is an antibody that is present eventually in the blood of most people with rheumatoid arthritis. (An antibody is a special protein made by the immune system that normally helps fight foreign substances in the body.) Not all people with rheumatoid arthritis test positive for rheumatoid factor, and some people test positive for rheumatoid factor, yet never develop the disease. Rheumatoid factor also can be positive in some other diseases; however, a positive RF in a person who has symptoms consistent with those of rheumatoid arthritis can be useful in confirming a diagnosis.

Positive RF test results may also be seen in healthy people and in people with conditions such as: endocarditis; systemic lupus erythematosus (lupus); tuberculosis; syphilis; sarcoidosis; cancer; viral infection; or disease of the liver, lung, or kidney. The RF test is not used to diagnose or monitor these other conditions.

As you were diagnosed of having Mitral valve prolapse there are chances of you developing Infective endocarditis which would give rise to most of your complaints.
http://emedicine.medscape.com/article/155494-followup
http://emedicine.medscape.com/article/896540-overview

This seems to be less of ENT/Infectious disease. I would recommend you to consult a good Physician (Not General Practitioners).

Regards
OHNS2010

[Ahmed34]

It seems there are ID specialists in your city. Google search referred me to Manipal Hospital, Bangalore. I am not sure as it's only a Google search. You should check out if you can.

Do you have any long standing allergy problems? We usually call them sinus problems (sinusitis). To me it seems like a manifestation of allergy. Even the rash you described on your palms can occur in allergic conditions. Are there any particular areas on the palms where you got the vesicles ... like sides / edges of the fingers/ palm? Anxiety and stress may increase the problem further, but they don't cause it. Your whole immune system may be activated. It may be autoimmune, too, as mentioned by Londres70. And as mentioned by OHNS2010, you could still be carrying a pharyngitis, reason being something unknown yet. It may just be your immune system acting smart here.

Just don't give up. Keep on exploring. Don't be afraid of consulting new doctors. You'll get your answers.