Managing Chronic Post-Nasal Drip with Fever and Neck Swelling: When to Seek Emergency Care

Long-term post-nasal drip has recently worsened, presenting symptoms such as fever, neck swelling, and pharyngeal pain?

I suspect I have an infection in my nose, which is causing post-nasal drip and resulting in coughing.
This symptom has persisted for about six months (since April) and has not improved despite ongoing medical treatment.
Recently, I have also experienced fever.
An ENT clinic issued a referral for a chest evaluation.
Last Friday (10/6), during a medical visit, it was discovered that my left tonsil is inflamed and enlarged.
Starting Saturday (10/7), I began to experience pain deep in the nasopharynx when swallowing.
There are also painful sores on the inside of my lips.
I can feel some lumps on the left side of my neck.
Currently (10/8), the swelling on the left side of my neck seems to have moved downward and is now located at the junction of the lower left neck and shoulder.
What should I do? Is it necessary to go to the emergency room, or can I wait until Monday to schedule a referral?

Tongxue, 20~29 year old female. Ask Date: 2023/10/08

Dr. Lin Wufu reply Internal Medicine

Hello, it is recommended to visit the ENT department of a major hospital today (10/9) to confirm what the neck mass is.
It is most likely lymphadenopathy, which is just an inflammatory response, possibly caused by a new wave of tonsillitis starting from 10/6.
This is separate from your original cough issue.
Therefore, you should consult both the ENT and Pulmonary departments at the major hospital!

Reply Date: 2023/10/08

More Info

Based on the symptoms you've described, it is crucial to take your situation seriously. Chronic post-nasal drip, especially when accompanied by fever, neck swelling, and significant throat pain, can indicate a more serious underlying condition that requires prompt medical attention.

Understanding Your Symptoms
1. Chronic Post-Nasal Drip: This condition often results from allergies, sinus infections, or other nasal issues. When mucus accumulates in the throat, it can lead to coughing, throat irritation, and even infections if not managed properly.

2. Fever: The presence of fever suggests that your body is fighting an infection. This could be related to your nasal issues or could indicate a secondary infection, especially given the inflammation of your tonsils.

3. Swollen Tonsils: The enlargement of the left tonsil indicates possible tonsillitis, which can be viral or bacterial. If it's bacterial, it may require antibiotics for treatment.

4. Neck Swelling: The swelling in your neck, particularly if it is moving downwards, could be lymphadenopathy, which is often a response to infection. It’s essential to monitor this closely, as it can indicate the spread of infection.

5. Mouth Ulcers: Painful sores inside your mouth can be a sign of viral infections, stress, or even nutritional deficiencies. They can also complicate swallowing and contribute to discomfort.

When to Seek Emergency Care
Given your symptoms, especially the combination of fever, significant neck swelling, and throat pain, it is advisable to seek emergency care rather than waiting for a scheduled appointment. Here are some specific reasons to consider:
- Difficulty Swallowing or Breathing: If you experience any difficulty swallowing or breathing, this is a medical emergency.

- Rapidly Increasing Swelling: If the swelling in your neck continues to increase or spreads, it could indicate a serious infection that may require immediate intervention.

- High Fever: A persistent fever, especially if it exceeds 101°F (38.3°C), warrants immediate medical evaluation.

- Severe Pain: If the pain becomes unbearable or is not relieved by over-the-counter medications, you should seek care.

Recommendations
1. Emergency Room Visit: Given the severity of your symptoms, particularly the fever and neck swelling, it would be prudent to visit the emergency room. They can perform a thorough examination, including imaging studies if necessary, to assess the extent of your condition.

2. Follow-Up Care: If you are diagnosed with an infection, ensure you follow the prescribed treatment plan, which may include antibiotics if a bacterial infection is confirmed.

3. Hydration and Rest: While waiting for medical care, stay hydrated and rest as much as possible. This can help your body fight off infection.

4. Monitor Symptoms: Keep a close eye on your symptoms. If you notice any changes, such as increased difficulty breathing, severe pain, or spreading swelling, seek immediate medical attention.

Conclusion
In summary, your symptoms indicate a potentially serious condition that requires prompt medical evaluation. Do not hesitate to go to the emergency room, as timely intervention can prevent complications and ensure appropriate treatment. Your health and safety are paramount, and it is better to err on the side of caution when dealing with symptoms like these.

Similar Q&A

Managing Post-Nasal Drip: Effective Solutions for ENT Issues

Hello, I have some questions: Two to three years ago, I underwent surgery for a deviated septum and turbinate hypertrophy. Since then, whenever it’s cold or in an air-conditioned room, I experience constant post-nasal drip, throat irritation, and coughing. These symptoms improve ...

Dr. Hu Kexin reply Otolaryngology
Hello: Your symptoms appear to be related to allergies; however, it is still recommended that you visit an otolaryngologist for a thorough examination to confirm the cause and receive appropriate treatment.

Understanding Nasal Drip with Blood: When to Seek ENT Care

Hello Dr. Zheng: In mid-February, I experienced headaches, fatigue, nasal congestion, and a runny nose. I visited the clinic three times without improvement, and finally, I couldn't stand it anymore and went to the emergency room where I was tested for influenza and had an X...

Dr. Zheng Jueyi reply Otolaryngology
Hello, if you are concerned, you can visit a hospital or clinic's otolaryngology department to have your nasopharynx examined. Generally, this can be done using a mirror or a nasopharyngoscope. Wishing you safety and health. Sincerely, Dr. Cheng Jue-Yi, Director of the Otola...

Understanding Your ENT Symptoms: When to Seek a Second Opinion

Hello Doctor: I have been experiencing frequent headaches and ear pain lately, along with continuous postnasal drip. Sometimes I can even taste a strange flavor. Additionally, I have pain at the back of my neck, specifically behind my ears. I visited an ENT specialist who said th...

Dr. Ye Dawei reply Otolaryngology
Tony: Your issue is likely due to a deviated septum, which can also cause headaches. However, please come to the clinic for a detailed endoscopic examination to gain a clearer understanding of your condition. Attached is an article for your reference titled "The 'Cure-A...

Persistent Sore Throat: When to Seek Medical Attention?

Recently, I experienced a sore throat and swelling that led to a fever. I visited a clinic and was told it was a common cold, but my throat inflammation was quite severe. After taking medication, I started to develop symptoms like nasal congestion and runny nose. After taking med...

Dr. Zheng Jueyi reply Otolaryngology
Hello: If most of the symptoms have improved, you may continue to visit the clinic for medication or drink plenty of water and monitor your condition. Wishing you peace and health. Sincerely, Dr. Cheng Jue-Yi, Director of the Department of Otolaryngology, Taoyuan Hospital, Minist...