Concerns About Ear Infection and Associated Symptoms
Throughout my life, I have experienced persistent discomfort in my ears. For the past three years, I've been dealing with significant itching, soreness, an unpleasant odor, and discharge. Finally, in late November, I sought medical help for this ongoing issue. The doctor performed a scrape of my ear and prescribed two rounds of antibiotic ear spray. Unfortunately, these treatments did not resolve the infection, leading to a prescription for Amoxicillin, which also failed to clear it. Meanwhile, I developed a chronic cough that worsened over a two-week span. Afterward, I returned to the doctor to address both the continuing ear infection and the cough. I was given Clarithromycin, and a swab was taken from my ear in hopes that this antibiotic would tackle both ailments. Just three days later, I received a call from the ENT clinic followed by another call from my GP, who advised that I start taking Metronidazole in conjunction with finishing my Clarithromycin course. Upon reviewing my NHS app, I found the swab results indicating 'abnormal: Anaerobes ISOLATED.' This discovery has left me feeling concerned, and I've been researching the implications. Should I be worried about severe complications like necrosis, meningitis, or brain abscesses? Additionally, does the infection relate to the cough I have, which has certainly lessened, although it remains bothersome as I enter week four? I’ve also been struggling with overwhelming fatigue to the extent that falling asleep at work has become a frequent occurrence. Furthermore, I've been experiencing excruciating pain in my toes, for which arthritis has been ruled out. My thyroid tests showed a borderline TSH level, yet no further examination was suggested. I'm curious if all these symptoms could be interconnected. Currently, I’m on day three of Metronidazole treatment, but my ear condition shows no sign of improvement. I'm seeking any insights, advice, or suggestions on how to manage this situation.
Answers (1)
7/11/2025, 11:40:40 PM
OpenHealth AI
I understand that you're dealing with a complicated situation involving persistent ear issues, a chronic cough, fatigue, and unexplained toe pain. It’s important to address each of these concerns calmly while focusing on the steps you can take.
Summary of Key Points:
- Persistent ear symptoms may require a comprehensive approach to treatment.
- Your cough and fatigue may be linked to your ear infection or separate issues.
- Ongoing symptoms warrant close monitoring and strategic self-care.
- Assessing the connection between your symptoms and overall health is crucial.
Explanation:
- Ear Infection: An ongoing ear infection—especially with abnormal swab results indicating anaerobes—suggests a resistant type of infection or underlying issue that typical treatments may not resolve. It’s understandable to feel anxious about the implications of such bacteria, but serious complications like necrosis or meningitis are rare without significant other health issues.
- Chronic Cough: This can sometimes be connected to an upper respiratory issue resulting from the ear condition or even post-nasal drip. The fact that it has somewhat improved is a positive sign.
- Fatigue: Overwhelming fatigue can stem from several factors, including chronic infection, sleep quality, or possibly hormonal imbalances, given your borderline thyroid results.
- Toe Pain: Though arthritis has been ruled out, other causes like neuropathy or circulation issues could be worth exploring.
Next Steps:
- Continue Medication: Finish the Metronidazole and Clarithromycin course as directed. Monitor for any changes in your symptoms, particularly any worsening or side effects.
- Symptom Diary: Keep a detailed record of your symptoms, including the frequency and intensity of your cough, ear pain, fatigue levels, and any other relevant changes. This will be useful for your healthcare provider in understanding your situation better.
- Hydration and Care: Stay well-hydrated and consider using warm compresses on your ear to alleviate discomfort. Avoiding irritants like smoke or strong odors can also help.
- Follow Up: Given the complexity of your symptoms, it would be prudent to schedule a follow-up appointment with your GP or ENT specialist within the next week. Discuss your ongoing concerns, including the cough, fatigue, and toe pain, and ask about further tests—or referrals if needed.
- Explore Thyroid Function: If fatigue persists, advocate for additional thyroid testing or an evaluation of other potential causes, like sleep disorders or nutritional deficiencies.
- Seek Support: If you're struggling with fatigue significantly affecting your daily life, consider discussing behavioral strategies for managing fatigue, including lifestyle modifications or possibly seeing a specialist if symptoms fail to improve.
These steps can help you manage your current situation more effectively. Please continue to monitor your symptoms and seek medical care as needed. Your concerns are valid, and getting to the root of your issues is important for your overall health and well-being.
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# 7-Month-Old Child with Abernethy Malformation - Exploring Treatment Options ## [7-Month-Old] Identified with Abernethy Malformation (Congenital Portosystemic Shunt) - Treatment Methods? **Age:** 7 months **Gender:** Female **Height:** Age-appropriate **Weight:** Currently 9 kg, was 2.8 kg at birth **Ethnicity:** Asian **Duration of Symptoms:** Present since birth **Location:** Uzbekistan **Pre-existing Health Issues:** Abernethy malformation (congenital portosystemic shunt), liver hemangiomas, chronic jaundice, anemia **Current Treatments:** Supportive management --- ## INITIAL PRESENTATION (June 2025 - July 2025) Our daughter arrived on **June 27, 2025**, presenting with: - Birth weight: **2.8 kg** - Marked jaundice (yellowing of skin and sclera) - Pale or clay-colored stools - **Bilirubin level: 245 μmol/L** (typically <20) An immediate ultrasound indicated multiple liver anomalies, initially thought to be hemangiomas. --- ## FIRST COMPREHENSIVE ASSESSMENT (August 1, 2025 - 1 Month Old) ### Multislice Computed Tomography (MSCT) with 3-Phase Contrast (August 1, 2025): **RESULTS:** - 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Cons: Surgical scar, longer recovery time (7-14 days in hospital) - Duration: 2-4 hours ### Option 3: **Liver Transplantation** - We have been advised this is not necessary as the portal vein is functional and liver health is improving. --- ## SPECIFIC QUESTIONS TO CONSIDER: 1. **With a functional portal vein (6.1 mm) and improving liver function (ALT normalized), is it advisable to pursue endovascular closure as the preferred treatment?** 2. **Despite ALT levels improving, the bilirubin remains consistently high (242). Should this be a cause for concern? Is there a prospect for it to normalize post shunt closure?** 3. **Are the hemangiomas/nodules (11.6×20.7 mm) linked to the shunt? Will they likely resolve following shunt repair?** 4. **How urgent is the proposed intervention? Is immediate action required, or is there flexibility to wait a few months?** 5. **What complications should we be vigilant for during the waiting period?** 6. **Regarding endovascular closure - what is the average success rate for infants aged 7 months? Are there concerns regarding the shunt size (9.9 mm)?** 7. **The measurement of the portal vein has shown improvement from 6.1 mm to 3.9 mm; should this be perceived as a positive sign or a reason for concern?** 8. **Are there special directives (diet modifications, medications) we should consider while awaiting the procedure?** 9. **Post-procedure, how long should we expect it might take for:** - Normalization of bilirubin levels? - Return of stool color to normal? - Resolution of jaundice? - Regression of hemangiomas? 10. **Can you recommend any specialized centers for pediatric Abernethy malformation treatments? We are located in Uzbekistan but are prepared to travel (to Turkey, Russia, South Korea, etc.)** --- ## ADDITIONAL INFORMATION - No family history of hepatic diseases - Pregnancy and delivery were normal - No additional congenital defects identified - Immunizations up to date - No history of bleeding disorders - No signs indicative of encephalopathy - Child is alert and engaged --- **I can supply actual MSCT images and comprehensive lab reports if they would be of assistance.** We sincerely appreciate any insights you can provide. We are striving to make the most informed decision regarding our daughter’s care and highly value expert medical opinions. **TL;DR:** 7-month-old diagnosed with Abernethy Type 2 malformation (9.9 mm portocaval shunt, patent portal vein). Liver functionality is improving (normalized ALT) while bilirubin remains elevated (242). Evaluating options between endovascular coil embolization and open surgery. Seeking expert advice on optimal treatment strategy and timing.