Chronic Sinusitis: Symptoms, Treatments, and Concerns - Otolaryngology

excuse me?

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Hello Doctor, I apologize for the lengthy message, but I wanted to provide clear details for better assessment.
I rarely catch colds and have no allergies, but starting in October, I began experiencing cold-like symptoms such as coughing, nasal congestion, and phlegm.
I also noticed an unusual odor and a bad taste in my mouth.
I visited doctors from October to November and took antibiotics.
Since November, I have been rinsing my nose 2-3 times a day, but my symptoms persisted with nasal congestion, phlegm, and a foul smell.
On December 19, I consulted an ENT specialist who performed an endoscopy and found yellow pus and crusting in my nasopharynx, which might be draining into my throat, causing me to cough.
A bacterial culture was done that day.
I was prescribed antibiotics for five days, but upon follow-up, the endoscopy showed no improvement.
On December 24, I was given another antibiotic for five days, but again, there was no improvement.
On December 28, the culture report indicated the presence of Pseudomonas aeruginosa.
The doctor prescribed ciprofloxacin for seven days, stating it was the most effective treatment.
However, after three days, I felt no better and continued to cough at night with a bad taste in my mouth.
On the fourth day (December 31), the doctor switched my medication to a coated tablet (Urokinase) for six days.
After completing the course, I felt slightly better.
On January 6, during a follow-up, the endoscopy showed no crusting.
The doctor advised against continuing antibiotics, but I was concerned about a relapse, so I requested to continue for a few more days.
The doctor agreed to extend the course for another five days.
I continued rinsing my nose and started using a nasal spray (Aminosyn).
However, by the fourth day, I experienced severe throat itching and coughing at night, along with nasal congestion and a foul smell, leading to a sleepless night.
The next morning, I woke up with nasal congestion and had to breathe through my mouth.
My nasal discharge was yellow-green and abundant, which puzzled me as to why rinsing my nose would produce so much mucus.
I continued to cough up yellow phlegm and felt very uncomfortable, prompting another visit to the doctor.
The doctor suspected sinusitis, but I had been on antibiotics for only one day.
I also noticed a heavy nasal tone in my voice.
On January 10, the doctor prescribed both ciprofloxacin and Urokinase for five days, along with medication for cold symptoms.
After five days, I still had yellow nasal discharge, albeit reduced, as it was not present every time I blew my nose.
On January 15, during a follow-up, I still had yellow nasal discharge, and the doctor suspected chronic sinusitis due to the prolonged symptoms since October.
He referred me to a larger hospital's ENT department for a possible CT scan.
On January 16, when I visited the hospital, I had no yellow nasal discharge during rinsing, and the doctor observed that my nasal condition appeared stable with white discharge, but no yellow mucus was noted, so no medication was prescribed.
I was advised to undergo a CT scan and return for further evaluation.
However, the next day (January 17), I woke up to find yellow nasal discharge and yellow phlegm again.
I have several questions:
1.
Since October, I have experienced nasal congestion primarily on the right side, with less on the left.
I often wake up congested, but sometimes it clears up after a while.
Occasionally, I feel like I can breathe, but when taking deep breaths, I sense congestion in the upper right side of my nose.
I can breathe, but I also experience pain on the right side of my head and a foul smell when blowing my nose.
Could this indicate sinusitis?
2.
If it is sinusitis, considering I have been on antibiotics since October, shouldn't the bacteria have been eradicated? Or could the Pseudomonas aeruginosa have migrated to my sinuses? The doctors have primarily focused on my nasopharynx, leading me to believe the discomfort was due to nasopharyngeal issues, but I have read that sinus issues can also cause similar symptoms.
What exactly is my condition?
3.
I have persistent salty phlegm in my throat, along with yellow phlegm.
Could this be post-nasal drip due to the mucus? Sometimes I feel like I have little mucus, yet my throat is still filled with phlegm.
I try to avoid coughing it up and instead clear my throat, but over time, I find myself needing to cough forcefully for relief.
4.
I have stopped taking medication and am only rinsing my nose and using the nasal spray.
Should I ignore the yellow nasal discharge? The CT scan is scheduled for mid-February, and I will likely receive the results by the end of February.
During this period, if I continue to have yellow nasal discharge, should I see a doctor again? If I do, will taking medication affect the accuracy of the CT scan?
5.
The nasal spray seems to be for allergic rhinitis, but I have no allergies.
Is it suitable for me to use? Sometimes I don't have nasal congestion, and when I use it, I feel like it drains into my throat.
Could this worsen my yellow nasal discharge?
6.
Some online sources suggest rinsing the nose only once in the morning and once at night, as excessive rinsing can keep the nasal cavity overly moist.
Is it okay for me to rinse 3-4 times a day, or should I reduce the frequency?
7.
I am very concerned about the Pseudomonas aeruginosa infection, as it is a difficult and dangerous bacterium.
I fear I may never recover.
I don't understand how I contracted it, especially since everyone in my household is fine.
Could dust be a factor, or is there an issue with my immune system? The information I found is alarming, often highlighting high mortality rates.
Thank you, Doctor.

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Feichang Yihuo de Nüzi, 30~39 year old female. Ask Date: 2023/01/17