Prolonged Tonsillitis: Symptoms, Treatment, and Concerns

The tonsillitis has not improved from March 25, 2023, to April 4, 2023?

On March 23, 2023, I initially experienced discomfort in my right tonsil and visited the ENT department on March 25 for examination, where I was diagnosed with acute tonsillitis.
I was prescribed antibiotics (Amoxicillin) for three days.
After completing the course, there was no improvement, so I returned for a follow-up on March 28.
The doctor noted significant improvement and prescribed another three days of antibiotics (Amoxicillin), advising me to return after finishing the medication.
However, on March 30, I experienced severe pain and swelling in the right tonsil, along with intense pain in my right ear and difficulty opening my mouth.
I went to a nearby clinic, where I was diagnosed with a peritonsillar abscess.
A fine needle aspiration was performed, yielding 30cc of pus and blood, and I continued antibiotic treatment.
Today (April 4), I returned for a follow-up and only a small amount of pus and blood was aspirated.
The doctor mentioned that I am improving, but I still experience pain at the aspiration site and in my ear, along with difficulty swallowing, which affects my sleep and eating.
I have several questions for the doctor:
1.
I have been taking Amoxicillin (March 23 - April 4) and a combination antibiotic, Anbicyn f.c.
(March 30 - April 4).
Will this have any adverse effects on my body?
2.
The pain has been affecting my ability to eat and sleep, and I only find slight relief with the prescribed pain medication (I still wake up in pain at night).
Should I consider hospitalization for treatment?
3.
Is it normal to have pain at the fine needle aspiration site (originally there was one painful spot, now there are two)?
4.
I feel that the treatment process for my throat has been prolonged.
Is there any specific reason for this? I am very concerned about my throat, as I have not had normal meals for two weeks, and my sleep is inconsistent.
I hope the doctor can provide me with some advice.

Niu Niu, 20~29 year old female. Ask Date: 2023/04/04

Dr. Li Jiaxuan reply Otolaryngology

It is recommended to undergo imaging studies and bacterial culture for the ruptured membrane of the tonsils, as it is prone to recurrent infections.
Wishing you good health.

Reply Date: 2023/04/04

More Info

Prolonged tonsillitis, particularly when it progresses to complications such as peritonsillar abscess, can be a significant health concern. Your experience highlights the complexities of managing tonsillitis and the potential for complications that can arise from it. Let's address your questions one by one, while also providing a broader understanding of prolonged tonsillitis, its symptoms, treatment options, and concerns.

1. Antibiotic Use and Side Effects: You mentioned taking amoxicillin and a combination antibiotic (Anbicyn f.c.) over a period of time. Generally, antibiotics like amoxicillin are well-tolerated, but prolonged use can lead to side effects such as gastrointestinal disturbances, allergic reactions, and the development of antibiotic-resistant bacteria. It’s crucial to complete the prescribed course, but if you experience significant side effects or if your symptoms do not improve, you should consult your healthcare provider. They may consider alternative treatments or further investigations.

2. Pain Management and Hospitalization: The pain you are experiencing, especially if it disrupts your ability to eat and sleep, is concerning. If over-the-counter pain relief is insufficient, discussing hospitalization with your doctor is a reasonable consideration. In a hospital setting, you could receive more intensive pain management, intravenous antibiotics, and possibly surgical intervention if necessary. Your comfort and ability to maintain nutrition are paramount, so do not hesitate to advocate for your needs.

3. Post-Aspiration Pain: It is not uncommon to experience pain at the site of a fine needle aspiration, especially if it was performed in an area with significant inflammation or infection. However, if the pain is worsening or if you develop new symptoms (such as fever, increased swelling, or drainage), it is essential to follow up with your healthcare provider. They may need to reassess the site or consider further interventions.

4. Duration of Treatment: The duration of your treatment may seem prolonged, especially if you are not experiencing significant improvement. Chronic or recurrent tonsillitis can sometimes lead to complications like abscess formation, which may require more extended treatment. If your symptoms persist beyond what is expected, or if you have concerns about the effectiveness of your treatment, it is important to communicate this with your doctor. They might consider additional diagnostic tests, such as imaging studies or a referral to an ENT specialist for further evaluation.

In summary, prolonged tonsillitis can lead to significant discomfort and complications. It is essential to monitor your symptoms closely and maintain open communication with your healthcare provider. If your pain persists, or if you have concerns about your treatment, do not hesitate to seek further medical advice. Your health and well-being are the top priority, and there are various treatment options available to help manage your symptoms effectively.

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