OpenHealth Q&A

Request for Assistance: Unexplained Symptoms and Recurring Pain

Subject: Seeking Insights on Persistent Health Issues 28 Years Old Height: 5'10" Weight: 190 lbs Current Medications: Recently started on antivirals (valacyclovir), antibiotics (amoxicillin) taken twice daily, nystatin four times daily, a steroid, and Zyrtec once daily. Also, I regularly take Phentermine, sertraline, and losartan. It all began last Thursday, March 27th, when I noticed my tonsils felt incredibly sore, accompanied by white pustules and body aches, but, curiously, no discomfort in my throat. I initially assumed it was a typical bout of tonsillitis, which I've experienced before. The following day, I visited my Primary Care Physician (PCP) for a routine checkup and shared my symptoms. A strep test returned negative, and I was given amoxicillin to address the suspected tonsil infection, as well as Zyrtec for potential allergy-related issues contributing to the inflammation. However, as the day progressed, I developed what I believed was a canker sore and tried various home remedies, all to no avail. My mouth grew increasingly tender, making eating quite painful. Additionally, my lymph nodes became swollen, and I continued to experience body aches. I also started to notice small pimple-like bumps in my genital region, attributing them to simple acne at the time. By Saturday, I woke up with severe body aches (pain rated at 7) and intensified tonsil discomfort, along with more white pustules. The canker sore was even more painful, rendering my mouth nearly unusable. Sunday was worse. I woke up in agony with tonsil pain peaking at a level 10 and mouth pain consistently at a 10 as well, preventing me from eating or even chewing. New sores appeared in my mouth, including on the roof, while the rawness and tenderness inside my mouth escalated, especially along my gum line. However, I noticed a slight improvement in my body aches. Come Monday, the suffering was unimaginable. Eating or chewing was out of the question as more sores formed, including a suspicious one on my lip that resembled a cold sore. My gums and the roof of my mouth were in serious distress, causing significant burning and bleeding. There was no throat pain, only issues confined to my mouth and tonsils, making dental hygiene impossible. In desperation, I sought urgent care due to the unbearable pain, where tests for strep and a full respiratory check again returned negative. An urgent care physician prescribed me an antiviral along with a specially formulated mouthwash while I was advised to continue my antibiotic regimen. The next day brought relentless pain, now also affecting the gum area above my lower right wisdom tooth, likely due to pericoronitis. This seemed like an unusual coincidence with all my other oral health issues. I noticed new cold sores developing, and my gums appeared puffy and white with strange blood-blister-like spots. My front gums did not hurt much but were quite alarming to look at. Seeking further help, I returned to my PCP, yet their response felt dismissive. They noted the appearance of herpes near my lip without examining my mouth thoroughly. I had to ask for an STI test myself. My doctor advised me to continue the antiviral treatment for the supposed herpes and prescribed prednisone to reduce tonsil swelling. My main concern remained: the severe discomfort in my mouth and the pain around the wisdom tooth. Despite enduring a night of agonizing pain and getting very little rest, I received STI test results that all came back negative. This was unexpected, particularly since additional bumps had emerged in my genital area and my lip was developing yet another cold sore. When I inquired if it could be thrush, my doctor suggested it might be a possibility, but my tongue didn’t show typical signs. Therefore, I was prescribed nystatin as a precaution, with instructions to persist with the antiviral. Today, I'm desperate for relief. I’m taking 800 mg of ibuprofen and 1000 mg of acetaminophen four times daily, but it barely alleviates the pain. The miracle mouthwash is a temporary solution, allowing me to brush my teeth, while I maintain my regimen of antivirals and antibiotics. I worry about the toll this extensive medication might take on my liver while I remain in pain, unable to discover the root of these symptoms. My breath has become foul from my inability to practice proper dental hygiene. Cold sores and genital irritations persist. Recently, I felt a burning sensation on my forearm, chest, and genital area, though there are no visible rashes. I'm reaching out in hopes of understanding my condition better; I’ve never faced issues like this beyond the infected tonsils, and my healthcare providers seem unhelpful. It feels as if my body is battling something significant while tests continue to yield nothing. Any insights or advice would be greatly appreciated.

Answers (1)

4/3/2025, 7:50:54 PM

OpenHealth AI

I'm sorry to hear about the challenging symptoms you’ve been experiencing. It sounds incredibly frustrating, and I want to assure you that there are potential explanations for your symptoms and ways to manage them moving forward.

Main Points

• You are experiencing multiple oral and genital symptoms that may be related to viral infections, inflammation, or potential allergies.
• There are immediate steps you can take to manage pain and discomfort while you work with healthcare providers on a clearer diagnosis and treatment plan.

Explanation

The combination of symptoms you described—including painful, ulcer-like lesions in your mouth, genital bumps, swollen tonsils, and severe body aches—suggests a possible viral etiology (such as herpes simplex virus considering your cold sore history). The negative tests for strep throat and STIs are reassuring in some regards but don’t rule out other viral conditions. Nystatin may help if thrush is a concern, but it's important to ensure proper diagnosis.

Your response to numerous medications, including antivirals and antibiotics, might be adding stress to your liver. This concern is valid, especially since you're taking medications for pain relief at high doses.

Actionable Steps

1. Continue pain management but consult on dosing:

   • Maintaining comfort is crucial. Consider discussing with your doctor the possibility of adjusting the dosage of ibuprofen and acetaminophen to ensure safe usage without exceeding the recommended limits.

2. Oral Care:

   • Use the prescribed mouthwash as directed but also consider gentle rinses with warm salt water to soothe your mouth. Avoid acidic or spicy foods that could aggravate your mouth sores.

3. Track Symptoms:

   • Keep a detailed diary noting when new symptoms arise, pain levels, and any changes after taking medication. This information can help your healthcare provider in assessing your condition.

4. Hydration and Nutrition:

   • Stay well-hydrated and consider smoothies or soft foods that require less chewing to ensure you get adequate nutrition while eating remains painful.

5. Revisit Healthcare Providers:

   • If your symptoms persist or worsen, consider seeking a second opinion from a specialist in infectious diseases or an oral-maxillofacial specialist who can provide more targeted assessments and treatment options.

6. Monitor for New Signs:

   • Pay attention to any new bumps, rashes, or systemic symptoms like fevers that may indicate an emerging condition.

7. Managing Anxiety:

   • Symptoms like burning sensations without visible rashes can sometimes be heightened by stress and anxiety. Consider relaxation techniques or speaking with a mental health professional if ongoing frustration is distressing.

I hope these steps provide you with some clarity and paths to manage your discomfort. If you have any further questions or need clarification on any points, please don’t hesitate to ask. You’re not alone in this; seeking support is always a good step forward.