I’ve dubbed the current infection that is hitting Phoenix… The Valley Virus. It is all over the place and has varying symptoms from cough, congestion, sore throat, to laryngitis and low grade fever. It is lasting 5-15 days and is not responsive to antibiotics. The symptomatic treatment list I recommend is below, and can also be found on page 95 of THE GUIDE at www.DoctorDougBooks.com
If your symptoms progress and worsen, if your fever gets higher and higher, or if you just cannot get over this infection, then perhaps you have a secondary bacteria that is contributing to symptoms and antibiotics will then be tried. But first, give a go with the list of options recommended below.
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UPPER RESPIRATORY INFECTION (URI)—INCLUDING:
SORE THROAT/STREP THROAT
SINUS SYMPTOMS/SINUSITIS
EAR PAIN/FULLNESS/MIDDLE EAR INFECTION
COUGH & MUCOUS PRODUCTION/BRONCHITIS
SORE THROAT:
Sore throat is probably the most common symptom of a respiratory tract infection and is usually part of a group of symptoms.
Although strep throat can occur in adults, it is generally seen only in children and adolescents and only rarely in adults.
Be concerned about strep throat if:
• Your only symptom is a sore throat…there are no sinus symptoms, drainage, or cough
• You have a mild or high fever (99.0 or above)
• You have been around children 1-14 years old, who have been diagnosed with strep throat
• Your significant other has strep throat
If your sore throat is accompanied by other symptoms including sinus congestion, drainage, cough, chest congestion….then you are unlikely to have strep throat and should be treated for a more general URI.
ANTIBIOTICS: If strep throat is more likely due to the above symptoms or history, then either a strep test should be obtained, or you should be treated with antibiotics without culture.
HOME TREATMENT: Symptom treatment is meant to reduce pain and fever and to improve energy and function.
These include:
• Salt Water Gargling….1 teaspoon of salt in a glass (any size) of warm water. Gargle for 15 seconds and spit. Do this repeatedly during the day for pain relief.
• Pain relief medications….Tylenol (2 pills…up to 4 times per day not to exceed total dose of 4000mg per day), Advil (2-3 pills taken 2-3 x per day not to exceed 2400mg per day), or Aleve (1-2 pills twice daily not to exceed 1000mg daily.
SINUS SYMPTOMS:
Sinus pressure, congestion, and drainage are the second most common symptoms in the URI complex. They can be severe, but rarely indicate a bacterial infection that requires antibiotics.
Be concerned about SINUSITIS (bacterial) if:
• You are around young children who have documented sinus and ear infections and then you develop symptoms involving the sinuses
• You have severe sinus pressure associated with high fever (over 100 degrees)
• Sinus symptom are the overwhelming symptoms you are experiencing, and there is very little sore throat or cough
• You have severe pain over the cheeks and nose when leaning forward.
If the sinus symptoms are accompanied by sore throat, cough, chest congestion….then you are less likely to have a sinus infection that requires antibiotics
ANTIBIOTICS:
Are indicated when the above list of symptoms is present. It is nearly impossible to diagnose sinusitis on examination at the office, so treatment with antibiotics is based on educated guesswork
HOME TREATMENTS:
Symptomatic relief can be obtained with:
• Decongestants (Sudafed 30mg…little red pill) Take 1 pill…. 1-4 times per day for relief of congestion and drainage. This is best taken earlier in the day or afternoon as it can keep you awake.
• Drying antihistamines (Chlortrimeton 4mg, Benedryl 25mg) Take 1 pills….1-4 times per day for relief of congestion and drainage. These are best taken later in the day or at night as they tend to make you tired.
• Mucous agents: Mucinex has mixed results, but some people do find it effective. Taking 2 pills twice daily can help mucous thin out and resolve more quickly, but this varies person-to-person. I generally do not recommend this much.
• Neti Pot: Rinsing the sinuses can give symptom relief to some patients. Neti Pots are now generally available in the pharmacy and allow rinsing of the sinuses.
EAR PAIN/FULLNESS
Ear pressure and congestion, with accompanied decreased hearing (not loss of hearing) are sometimes seen in the URI complex. They rarely indicate a bacterial infection that requires antibiotics.
Be concerned about EAR INFECTION (middle ear)if:
• You are around young children who have documented ear infections that are being treated with antibiotics.
• You have intense ear pain
If the ear symptoms are accompanied by sore throat, cough, chest congestion….then you are less likely to have an ear infection that requires antibiotics
ANTIBIOTICS:
Are generally not indicated unless there is evidence of infection on exam or you have definitely been exposed to a child with ear infections prior to developing your specific symptoms. Ear infections are straightforward to diagnose and this is best done in the office, with examination.
HOME TREATMENTS:
Symptomatic relief can be obtained with:
• Decongestants (Sudafed 30mg…little red pill) Take 1 pill…. 1-4 times per day for relief of congestion and drainage. This is best taken earlier in the day or afternoon as it can keep you awake.
• Drying antihistamines (Chlortrimeton 4mg, Benedryl 25mg) Take 1 pills….1-4 times per day for relief of congestion and drainage. These are best taken later in the day or at night as they tend to make you tired.
• Pain relief medications….Tylenol (2 pills…up to 4 times per day not to exceed total dose of 4000mg per day), Advil (2-3 pills taken 2-3 x per day not to exceed 2400mg per day), or Aleve (1-2 pills twice daily not to exceed 1000mg daily)
COUGH & MUCOUS PRODUCTION/BRONCHITIS
Cough and mucous production from the chest are very commonly seen in the URI complex. They can indicate the need for antibiotics with a bacterial infection, but generally this is not required.
Be concerned about BACTERIAL BRONCHITIS if:
• Your illness is progressively worsening and has lasted over 5 days without showing improvement
• Cough is the primary symptom and is associated with yellow mucous production. Other colors of mucous may indicated infection, including grey, green, or brown mucous.
• There is high fever (over 100 degrees) and this is occurring away from the flu season timeframe
ANTIBIOTICS:
Are indicated sometimes in the setting of persisting mucous production and fever. Bronchitis can be difficult to diagnose with certainty on examination and the purpose of the exam is this setting is to make sure pneumonia is not present.
HOME TREATMENTS:
Symptomatic relief can be obtained with:
• Cough Suppressants: (Robitussin DM or Delsym). Take 2 teaspoons as indicated on the bottle to prevent excessive coughing
• Drying antihistamines (Chlortrimeton 4mg, Benedryl 25mg) Take 1 pills….1-4 times per day for relief of congestion and mucous production. These are best taken later in the day or at night as they tend to make you tired.
• Mucous agents: Mucinex has mixed results, but some people do find it effective. Taking 2 pills twice daily can help make mucous thin out and resolve more quickly, but this varies person-to-person. I generally do not recommend this medication.