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Sorethroat, shortness of breath with raised blisters in throat.

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I am a 38 year old male. I have had a sore throat with kind of raised blisters on the back of my throat. Shortness of breath. I quit smoking cigarettes prior to the throat problem. I have also been coughing up grey/ green phlegm. I have been to my primary physician who gave me an inhaler and a ear/nose / throat doctor that suspected it is acid reflux and prescribed Prilosec(or something) I did have a bit of acid reflux and that has been better. I also took 5 days of steroids and a 5 day z pack, the zpack seemed to clear up the cough some, but throat seems as bad if not worse. As embarrassed as I am, I didn't mention one main factor to doctors.

Category: Internal Medicine Specialist

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Category: HIV- AIDS Specialist
 22 Doctors Online

Hello,
Thank you for your query at DoctorSpring.com
I understand your concern.
So you nave persistent throat pain and some shortness in breath. The sore throat seems to be due to an acute pharyngitis which again can be secondary to smoking, acid reflux, viral/bacterial causes. Since you also have some shortness in breath, it can be a reaction the the smoking. You have already quit smoking and it is best way forward. What smoking does is, it makes the environment in the throat conducive for further viral/bacterial infections, by hampering the mucus production.
I will advise you the following medicines for a week and it should recover.
1) Tab. Amoxycillin + Clavulanic Acid ( Augmentin ) 650 mg twice daily for 5-7 days after food.
2) Betadine throat gargling 2-3 times a day.
3) Syp. Codeine 2 teaspoons twice daily ( till cough subsides, it will also help in bringing the throat secretions out )
4) Tab. Montelukast 10 mg once at bed time for3 days.
Augmentin and Codeine are prescription drugs. You need the medicines for sure, and you can get it from your local physician.
Kindly continue the medicines for a couple of days and let me know if there is improvement.
Regards.


Patient replied :

I went to my doctor and he gave me a script to get a chest x-ray. I got the chect x-ray done and he said it was negative. He then gave me a script for moxifloxacin. I am on 4th day of that, but it doesn't seem to be improving. I had smoked what i thought was CC for a few months prior to his and am worried that I burned my esopagus or have some type of lung/ throat cancer. I am still able to cough up a grey/ brown mucus if I try. This has been going on 6 weeks now. Is there anything else I can do?


Hello,
Please do not worry about cancer because you're 38 and lung or throat cancer can occur only if there is more than 20 years old patientsmoking history ( at least 1-2 packs per day ), or if there is a history or chewing tobacco. So can you give me your complete smoking history? When did you start smoking? How many years old patientdid you smoke? And how many cigarettes or packets per day?
As I initially told you, i still feel it is pharyngitis. That's why i suggested Augmentin, and Betadine gargling. I also asked you to take Tab. Montelukast. Did you take these medicines? Augmentin would have been a better choice antibiotic since it works really well for throat infections.
Regards.


Patient replied :

I showed your response to my doctor and he ordered x-ray and precribed the Moxifloxican. I have smoked for 20 years, probably averaging under a pack a day. I had a full physical done about 6 months ago and everything looked great. Please don;t judge, but had a bad influence and bad choices over the past 6 months, which included smoking crack cocaine for a few months. Never had before, never will again, but I did. This started after the last time that I did (6 weeks ago). I have not smoked anything in the past 6 weeks.
I went to ENT Specialist as well and he scoped my throat and said it looked irratated and prescibed antiacids. I am now taking prilosec and zantac and the heartburm feels better, but the burning in my neck does not. It feels like a radiating pain that starts at my breastplate and goes all the way around.


Hello,
The comforting factor is that Chest X RAY is normal.
Also in cases of lung cancer the initial presentation will be hemoptysis invariably.
The little raised blisters are typical of pharyngitis, which could develop secondary to smoking/ cocaine. But in presence of green phlegm it seems like a URTI that has progressed to LRTI.
Since you started Moxifloxacin, you should continue it for a few more days. Also Montelukast will be helpful.
Since you smoked under a pack, it is not that harmful. And the fact that your physical examination was great, there is nothing to worry about.
It's just an infection that is taking longer time to heal.
You have another follow up with me. So try taking Moxiflox for another 3 days, and also get Montelukast. You won't need a prescription for that. If possible take Syrup Codeine once at bed time for 3 days. Update me after 3 days.
Once again I reassure you do not have anything serious. Definitely not throat/lung cancer.
Regards.


Patient replied :

I appreciate your timely response and realixze this is my last follow up. I don;t know what to do from here. I seem to be getting worse and nothing has helped. I have taken multiple rounds of antibiotics, s=chest x-ray, quit smoking, etc... I know you said that you were sure it was just a chest infection. If that is the case, then I will wait it out. But, my throat has gotten worse/ sorer and the bubbles/ blisters are more prevalant. I have pains in my back and may neck is sore all over. As I mentioned, I smoked a lot of CC prior to this occurring. It is not something I have done much of prior, but did for a few months. Is there a chance that what I was smoking was mixed with something toxic? I am not sure if I should go back to my doctor or to a pulminologist? Thanks again.


Hello,
I still strongly believe it was nothing to do with cancer and no smoking itself apart from the tobacco content won't have any additional toxins. Tobacco is the toxin that causes all the harm.
I will recommend you visit a pulmonologist, who if required can culture your phlegm or sputum, and proceed accordingly.
Regards.


Dr. Jaydeep Tripathy
Category: HIV- AIDS Specialist
Experience: 
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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