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Can anyone else smell this odor as well?
Alright, any alteration in the taste?
Alright, do these smells turn on and off during the day or do they remain fairly constant throughout the day?
Okay, do they aggravate when you are emotional, sneeze or sniff in forcefully?
Have you had a CT scan of the nasal sinuses and the brain?
Okay, post nasal drip?
Okay, any previously diagnosed medical conditions?
Sure. Have the antibiotics been able to take the symptoms down while you've been on the,?
Okay, thank you for being very patient during the q and a.
There are a few things that come to mind, the first thing that I would like you to get done is a nasal swab and have it sent for fungal cultures since it is obvious that this is not bacterial and more likely to be fungal in origin, because it is recurrent, you've had multiple course of antibiotic therapy and you are on chemotherapy due to the metastatic tonsillar ca.
The chemotherapeutic drugs, multiple courses of antibiotics render the organisms resistant and in the back drop of resistant recurrent bacterial infections, fungal infections can take charge. And these are a notable cause of bad odor with nasal discharge.
You can be started on empirical antifungal nasal creams as well as oral anti fungal agents while you wait for the culture results to come by, once they are back and a fungal infection has been identified, these anti fungals can be changed to the ones that the fungus is sensitive to.
Sometimes, due to colonization, it is best to have a bilateral antral washout done, in which the ENT washes the sinuses and the nose and naso pharynx with antifungals, antibiotic and irrigation solution.
Along with some endoscopic debridement of identifiable colonies of the fungus.
This reduces the fungal load and the anti fungals work better.
This combination therapy has shown the best results with fungal colonization with minimum recurrence.
Once, the symptoms subside and the infection is under control, you will need to remain on anti fungals prophylactically for 6 to 8 months.
To avoid any recurrence.
And another thing, please do get a CT scan with contrast done of the brain, if you have not had that done.
Do you have any more queries, related to this?
Thanks a lot. And please do take care.
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Thank you, Loni.