Persistent Sore Throat and Fever: When to Seek Further Medical Help

Tonsillitis has not improved after three days of medication, with recurrent fever?

On April 13, I felt discomfort in my throat.
By April 15, the discomfort turned into pain, so I visited an ENT specialist.
The doctor prescribed antibiotics and antipyretics, but after taking them all day, there was no effect.
On April 16, I started to have a fever of 38.8°C around noon and went to a second ENT clinic.
They mentioned that the medications prescribed were similar to the first clinic, but since I was still experiencing a fever, they suggested I take a rapid test and then discharged me.
In the afternoon, I used a rapid test kit, which confirmed a negative result.
By 6 PM, I went to a third ENT clinic.
They also stated that the medications were similar but were willing to prescribe a different antipyretic for me.
From noon to 6 PM, my fever ranged from 38.2°C to 39°C.
After taking the medication in the evening, I experienced noticeable pain relief and a reduction in fever, but during the night, I started feeling chills and throat pain again, so I took more medication.
In the morning, after the medication wore off, the situation remained the same; my throat still showed no improvement, and my temperature was 37.7°C.
I would like to know what I should do now, as the throat pain has not alleviated for three days.

Zhuang Yu-ting, 20~29 year old female. Ask Date: 2022/04/17

Dr. Ji Zhaoyun reply Otolaryngology

Hello, based on your situation, I recommend visiting a hospital.
If necessary, you may require inpatient treatment.
Wishing you peace and good health.

Reply Date: 2022/04/17

More Info

Persistent sore throat and fever can be quite distressing, especially when initial treatments do not yield the expected relief. Based on your description, it seems that you have been experiencing a sore throat and fever for several days, and despite visiting multiple ENT specialists and receiving antibiotics and antipyretics, your symptoms have not improved significantly.
When dealing with persistent symptoms like yours, it is essential to consider several factors. First, the duration and severity of your symptoms are critical. A sore throat accompanied by fever lasting more than a few days warrants further investigation. While viral infections are the most common cause of sore throats, bacterial infections, such as streptococcal pharyngitis (strep throat), can also be responsible and may require specific antibiotic treatment.
Given that you have already undergone rapid antigen testing for COVID-19, which returned negative, it would be prudent to consider other potential causes of your symptoms. If you have not yet undergone a throat culture, this could be a valuable next step. A throat culture can help identify if a bacterial infection is present, particularly if strep throat is suspected.
Additionally, if your symptoms persist despite treatment, it may be beneficial to explore other potential causes of your sore throat and fever. Conditions such as infectious mononucleosis, tonsillitis, or even less common infections like epiglottitis or peritonsillar abscess could be at play. These conditions may require different management strategies, including possible hospitalization or surgical intervention in severe cases.

Moreover, if you experience any of the following symptoms, you should seek immediate medical attention:
- Difficulty breathing or swallowing
- Severe pain that does not improve with medication
- A rash or other systemic symptoms
- Signs of dehydration, such as decreased urination or dizziness
In the meantime, supportive care is essential. Staying well-hydrated, using throat lozenges, and gargling with warm salt water may provide some relief. Over-the-counter pain relievers like ibuprofen or acetaminophen can help manage fever and discomfort, but it’s crucial to follow the dosing instructions and consult with your healthcare provider if you have any concerns about medication interactions or side effects.

If your symptoms continue to worsen or do not improve within the next few days, I strongly recommend returning to your healthcare provider or seeking a second opinion from a different specialist. They may consider additional diagnostic tests, such as blood tests or imaging studies, to rule out other underlying conditions.

In summary, persistent sore throat and fever can indicate various underlying issues, and it is essential to continue seeking medical help until you receive a definitive diagnosis and appropriate treatment. Your health and comfort are paramount, so do not hesitate to advocate for yourself in the healthcare system.

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