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Dr Basu
Dr Basu, Experienced Specialist
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Experience:  MD
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49F Came down with severe sore throat on Thursday. Could

Customer Question

Hi, 49F
Came down with severe sore throat on Thursday. Could hardly swallow or talk. Saw GP. With light, verified red, inflamed tonsils. Yellow pus evident hanging at back of throat. No fever. Nodes only slightly swollen. Rapid strep test was negative. Prescribed Zpack, told to gargle with salt water.
3 days later, no change. Throat very inflamed hard to swallow. Noticed large stream of yellow pus hanging at back of throat this am. Tried to remove with a q-tip and I guess I irritated it enough that I coughed and was able to spit out a huge glob of dark, yellow thick pus-like gunk (so sorry!!). First question- where is this pus coming from? I am not congested and have no sinus pain, so it did not seem to be post nasal drip? I am also not coughing-- anything that does come up seems to be an irritant from what is coming DOWN. (I have had bronchitis several times and it's very different from this- I will cough up dark phlegm-- but not like this and it's very definitely present at the back of my throat).
I realize infections can be bacterial or viral and if the latter, the Zpk will do little. I was a "just in case."
Is there anything I can do/should be doing-- other than trying to be patient as this may be viral?
Is the pus indicative of tonsillitis? I thought this was mainly a childhood issue and recall having as a kid, but with a fever etc
Right now-- I'm taking ibuprofen, lots of tea with honey, chicken soup.
I'm wondering if I should see an ENT or---- Have never had anything like this before.
Thank you kindly for any advice you can offer.
(Note- I do have a breast cancer history. 2000 and 2008. No nodal involvement or mets. Am checked every 6 mo. Had a chest CT last year at this time for bronchitis- no issues identified. Again, this does not seem bronchial-- but thought I should mention)
Submitted: 1 year ago.
Category: Medical
Expert:  Dr Basu replied 1 year ago.

Hi there,
This is Dr Basu, experienced Internal Medicine Specialist.
I am here to address your concerns and provide great service.

The pus or secretion can be from the tonsils themselves.

An some sinus secretion also may collect at the back of throat.

If the tonsils look better than before, then probably no new infection.

If zpack helped then it was likely bacterial infection.

In case of viral infection the symptoms tend to subside in 7-10 days.

You should use warm saline water for gurgling 2-3 times a day.

No other specific treatment recommended except for symptoms.

If you notice worsening of symptoms in next 3 days then you will need another clinical evaluation.

Otherwise, in most cases, you will recover fully.
Best wishes,
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