Swallowing Obstruction

Dear Ask The Doctor: My husband started running a fever Saturday, 7-10. It got up to 104 F. We alternated ibuprofen and acetaminophen to keep it down. Monday, he began feeling like there was something obstructing his swallowing. When he swallows, he feels like it won't go down. He says it hurts constantly, and is much worse when he tries to eat or drink. We've been to two doctors and they did blood work. His bilirubin was slightly high 1.4, so they sent him for an ultrasound of his gallbladder. It was negative. His WBCs were normal, so they are assuming his fever was from a virus. They gave him Zegerid and Donnatal and told him to use Maalox as needed. This has given him no relief. He had some problems with acid reflux a couple years ago and says this is totally different. He is eating next to nothing--two to three bites at each meal and can hardly swallow. What else could this be?

Dear Timothy: Difficulty swallowing and a high fever suggest a pharyngeal abscess (upper throat abscess). This is a surgical emergency which requires immediate drainage under general anesthesia and intravenous antibiotics. Occasionally, there is a delayed response by the body to such infections and thus no eveidence of infection in the blood test. That explains the normal WBC. I suggest seeing an ENT surgeon ASAP to confirm the diagnosis and start the appropriate treatment.