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Dr. D. Love
Dr. D. Love, Doctor
Category: Medical
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Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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I'm from America living in Zimbabwe. While I was home for

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I'm from America living in Zimbabwe. While I was home for 5 weeks just awhile back, I went to the doctor with what he believed to be a sinus infection. He prescribed Augmentin. I also went to the ear, nose and throat specialist, he did not look in my nose, but also told me that Augmentin was the best treatment. I have been on Augmentin for nearly 3 weeks and symptoms have subsided, however, they have not gone away. I still have a morning cough which I cough up quite a bit of phegm - whitish. After this I no longer cough up phlegm, but have a bit of a cough throughout the day. I do not cough at night. I do not have chest pains. I can breath just fine. When I blow my nose, I have a yellowish fluid still and still blow my nose quite often. I sound just as stuffy as I did before I began Augmentin. My ears have cleared up a bit. I am suspecting that there is a different challenge that I am facing other than just a sinus infection. I would be grateful for your help.
Hello from JustAnswer.

There are several possibilities to consider in this situation.

First, it is important to note that the cough can be due to drainage from the sinuses. And many people will notice a greater amount of coughing first thing in the morning because of accumulated mucus during the course of the night.

It is still possible that this is solely a persistent sinus infection. The doctors were correct that the Augmentin is one of the best medicines for a sinus infection. However, there is no antibiotic that will work 100% of the time. So, it could be a persistent infection because of a germ that is resistant to the Augmentin. It is also possible that there could be a persistent infection related to an anatomic issue with the sinuses, such as a polyp that is blocking proper drainage of the sinuses. In this situation, even an antibiotic that is active against the offending germ will not be able to get control of the infection.

It is possible that the infection has spread beyond the sinuses, such as into the lungs. However, there would usually be more coughing of phlegm throughout the day and there would frequently be other symptoms, such as shortness of breath or chest pain. So, it would be less likely that the infection has spread into the chest.

There are also certain anatomic conditions that can cause symptoms in the absence of infection. In a young adult, these are usually benign conditions, and would only need treatment when they are causing significant symptoms.

In this situation, the usual next step would be an imaging test of the sinuses, most often a CT scan of the sinuses. The CT scan is sensitive at detecting an infection of the various sinuses. It also would identify anatomic conditions within the sinuses that may cause persistent infection or symptoms without an infection.

If I can provide any further information, please let me know.
Customer: replied 2 years ago.

This is helpful. Does the CT scan detect polyps in the nose? Does the CT scan detect infection in the lungs? What else does the CT scan determine? I am in the bush of Zimbabwe right now, but I'm hoping there is a place I could get a CT scan. Shall I continue my prescription of Augmentin for the next week? I have only a week left.

A CT scan would detect a polyp of the nose that is large enough to block drainage of a sinus. It also can detect cysts or other growths in the sinuses, the vast majority of which are benign in young adults.

The CT scan of the sinuses would not detect an infection of the lungs, but since this is less likely with the symtoms that you describe, there is no reason to assesss the lungs until the sinuses are fully assessed.

Yes, it would be appropriate to continue the Augmentin for the next week.
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Customer: replied 2 years ago.

Thank you again! I will do my best to try and find a place that does a CT scan in Zimbabwe. In the case that I cannot get a CT scan, what do you recommend?

If you cannot get a CT scan, the best that can be done is to try an antibiotic that is in a different chemical class and covers slightly different germs, such as Bactrim. But that would require that you can find a doctor that can prescribe the antibiotic.