Q: My son has been suffering for the last 6 months from a continuous feeling of insufficiency while breathing with occasional cough and abnormal sounds while coughing. He also has cryptic tonsillitis with continuous formation of white pus-like exudate in the tonsillar crypts and granular pharyngitis for the last 10 years without any symptoms. His tonsils are normal in size and ENT doctors advised only antiseptic gargle and an occasional antibiotic treatment. His reports are as follows: Lung Function Test- Normal, ECG-Normal, echocardiography-Normal, MRI Scan of URT-Normal, Virtual Bronchoscopy-Normal, Chest X-Ray & CT of Lungs- Normal, Blood ASO Titre-Normal, Throat Swab & Sputum Culture- Positive ++ for Klebsiella species & Streptococcus viridans. Some doctors suggested that he may be suffering from chronic tracheitis due to prolonged effect of cryptic tonsillitis. Please confirm his diagnosis and advise further medical exam and treatment. I will be ever grateful as specialist doctors here in Kolkata are not sure about the diagnosis.

A:The symptoms sound like an allergic Sino-bronchitis. There could be a hidden reaction to an unknown allergen. The trachea can also be affected by this but the cough in tracheitis is very painful, which is not so in your sons case. He needs a properly humidified atmosphere either through steam inhalation or by drinking plenty of water to hydrate himself. Avoid antibiotics and don't use any cough syrups. I also feel that if the tonsils have pus points in it, then they may be a source of infection and it is not necessary for the throat swab to be positive for GABH or strep etc and the ASLO to be high. If judiciously the doctor feels that the tonsils are chronically infected, then a surgery on the tonsils can definitely help.