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Cause for fever and coughing out mucus from lungs.

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I am worried about my medical condition. I am 28 years old male with basic good health. It all started a 25th of January when I started to have flu-like symptoms. I had fever, sore throat and cough. After 3 days of resting I started to feel better in my throat but after two days or so, I started having pain deeper in my throat. That lasted 3 days with fever and I then I started to coughing out mucus from my lungs and my general feeling got better. This lasted until 9th of February and I already felt while during that period. I went out with friends and had a few beers in the nights. Didn't do any heavy lifting or went to gym. Just normal daily things.

Now 10th of February I started feeling ill again after I went to sing karaoke. It came slowly. First I started to feel tired and sneezing. I haven't had a fever really but I feel the body temperature is up occasionally (not all the time). I have been taking ibuprofen and paracetamol a few times. I have a little stinging pain in my chest, both sides (not in the middle). No other significant pain or symptons anywhere. I don't feel like I feel when I have flu (sore throat, etc). I have also had now some gas in my stomach. I don't know if it is related to this. It's been now three days and I don't feel it is getting better (but not significantly worse either). It is actually really strange because I can feel okay but after a few hours I feel tired again. I am currently in Langkawi Island in Malaysia on vacation and there are not really good hospitals here. I went to see a local doctor yesterday and he just gave me Strepsils and told to take it easy. My plan was staying here on island until end of the month.

I have also had irregular heart beat now for a month or so (started before I got ill at the first time). I feel that it is probably stress related because I have tendency to get that when I am stressed. I told the local doctor about my irregular heart beat and other symptoms but he was confident that I don't have myocarditis. He however didn't take any tests such as ECG, X-ray, so on. He measured my blood pressure (120/90) and my pulse was a bit high (80). He listened my lungs with stethoscope and that's it.

Now I am really worried about my health but it is not easy to go to a proper clinic. The nearest one is in Penang Island. 3.5hours in ferry. Please let me know your medical opinion and suggestion what I should do? Should I be worried about my condition?

Cancelled since no answer within 3 hours!

Category: Infectious Disease Specialist

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Category: HIV- AIDS Specialist
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Sorry for the inconvenience. I understand that you have cancelled your reply, no issues. Anyway I had drafted my reply before this, so just posting here. Please contact support for cancellation.


Hello and thankyou for approaching DoctorSpring.
I have gone through your case, and understand your concern.

From what you have described, you started with an upper respiratory tract infection( affecting your tonsil, pharynx in your throat), hence the flu like symptoms, fever sore throat and cough. But as it often happens the infection from the throat can go down causing a lower respiratory tract infection(affecting your lungs) . It is probable that you now have a lower respiratory tract infection, which was the cause of the mucus being coughed out, feeling tired, having a body temperature off and on and having the stinging chest pain.

The paracetamol and Ibuprofen will only give your symptomatic relief by taking care of the fever. It will not take care of the infection that is causing it.

I would suggest you take a course of antibiotics and the following medications. This is because of two reasons - 1. You have a travel history 2. You have symptoms suggestive of Streptococcal infection. Unlike in US, it is better not to have a wait and watch approach for initiating antibiotics.

1) C.Amoxicillin + Clavulanate 500 mg thrice daily for 7 days or T. Azithromycin 500 mg once a day for 3 days are the best options. The reason why I am mentioning the name is because you may be able to get it from a Nurse practisioner or even from Pharmacy itself. But you will need to take it under the guidance of a Doctor.
2) Continue with paracetamol thrice daily after meals for 3 days
3) Tab Prilosec once a day before meals for 5 days to take care of the gas in your stomach.
4) Mild warm saline gargle twice a day.

However if you feel that you have any of the following warning signs, visit the medical center immediately. If you feel you are having shortness of breath, Fever is high spiking, you notice blood in the sputum, severe sweating or you feel tired even with slight walking or your chest pain worsens.

The irregular heartbeat probably due to stress and fever. But considering the possibilty of Streptococcal infection I would like to know some additional information from you.

1.Do you have any joint pain (even small joints)
2. Any swelling, rashes ?
3. Is there swelling in your neck / underside of neck ?
4. Is the area endemic for Malaria ?
6. How is the cough now ? How does the sputum look ?

I hope this has helped. Feel free to follow up. You can reply as a followup

Dr. Jaydeep Tripathy
Category: HIV- AIDS Specialist
MBBS from Sri Ramachandra University in December 2011
M.Med (Family Medicine) - TNMGR University, Chennai
MBA-MPH in Public Health in March 2016, SRM University
Finished AFIH in March 2016, SRM University
MRCP ( UK ), Internal Medicine, Royal College of Physicians, June 2016
Fellowship in Diabetology from Martin Luther University in January 2017

Currently Resident Physician, in MD Radiodiagnosis - Kamakshi Memorial Hospital, Chennai
Dr. Jaydeep Tripathy and 4 other Medical Specialists are ready to help you

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