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Vaccine-triggered CFS linked to nasopharynx inflammation, and 81% cured or improved by treating this nasopharyngitis

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21
@Richard7, thanks!!!

I did a quick check at Ken Lassen's blog, fascinating stuff. Brief synopsis; genetic tendencies plus microbiome changes and stress leading to CFS? He's even from the Seattle area (US), which is where I'm at. I'll be doing more reading on him after I've satisfied some questions regarding the respiratory microbiome.

There is a ton of info on PubMed about respiratory microbiomes, multiple articles in regards to chronic rhinosinusitis (CRS).

CRS and nasal polyps appear to be related to shifts in the nasal microbiome, with polyp tissue containing elevated cytokines and chemokines, which drive an elevated b-cell response in the nose: www.ncbi.nlm.nih.gov/m/pubmed/27466846

And this article discusses the possible microbiome shift after pneumococcal vaccine which contained specific piliated strains: www.ncbi.nlm.nih.gov/pmc/articles/PMC5049726

On an interesting note, this recent study was regarding manuka honey irrigation: www.ncbi.nlm.nih.gov/m/pubmed/27935259

Yes, I'm having that same issue...throwing a bunch of different stuff at it at the same time ;)

Although, I am now inclined to think dealing with the gut and nose at the same time may be necessary. This appears to be a part of Ayurvedic treatment, nose and gut (and stress!) being managed at the same time. Detox too.

Which makes sense if antibiotic use is a precipitating factor in some cases. Antibiotics would affect the microbiome in the nose and gut, and would not equally affect all bacteria. Homeostasis between bacteria is delicate.

Maybe that's why the human breast milk in nasyam is used in ayurvedic medicine. Regulates the microbiome? Considering the posture of babies nursing, then spitting up, seems like the nasopharynx would get regular baths of breast milk.

Very curious stuff. I'm not advocating for the use of Ayurvedic treatments, but there are success stories, and reasons why it has survived this long as a treatment, IMO.

As an evolutionary adaptation, seems like sinus inflammation would be a way to contain that section of the microbiome. Like bacteria jail.

As regards to vaccines, the pneumococcal vaccine and HPV vaccine are both on the subunit/conjugate vaccine list: http://carrington.edu/blog/medical/vaccines/different-types-of-vaccines/

I'll be reading today to see what subunit/conjugate vaccines entail.

I hope you got some peace & quiet today :)
 

me/cfs 27931

Guest
Messages
1,294
I find significant relief to my chronic sinus congestion by taking Zicam dissolvable tablets twice a day as needed. I also experience relief from Valtrex (2g), LDN (9mg), and a nasal wash at bedtime.
Sadly, the effect of the Zicam wore off after about a month. It was nice while it lasted, though.

I was curious if anyone has tried using betadine solution on an applicator instead of zinc chloride as used in the study, and if it helped or not.
 

rosie26

Senior Member
Messages
2,446
Location
NZ
Of course, both sinuses and gut contain areas of lymphoid tissue (GALT & NALT).
Is it NALT or MALT ? I have big problems with this area of nasopharynx/sinus too, all throughout my ME and a few years before my ME symptoms really kicked in.
 

Richard7

Senior Member
Messages
772
Location
Australia
Hi, I thought I should post an update. I still have CFS ! -- and at least mild nasopharyngitis.

I have been hitting this with everything, so this is not science. I have still been using the dental probiotics, and the sinus ones http://lactobacto.com/tag/lactobacillus-sakei/. I have been swabbing twice a day every day and have also gone through some antifungals.

When I started the bleeding was at the moderate to severe level, it dropped markedly with the fluconazole and probiotics (for me for some reason kimchi juice worked better than Bactoferm B-2).

I am now no longer on the fluconazole (I took it for 27 days, and could not handle the last one side effects were just too much) and am now taking nystatin. (I took two weeks of nystatin before taking the fluconazole which had no effect on my nasopharynx but pretty much ended my diarrhoea (which is really cool) and I will take it for a while to deal with that.)

At the moment my nasopharyx is either mildly inflamed or clear. This last week some times both have come back with clear swabs, more often either the left or the right comes back mildly bloody - just a blush. I have used about 250 swabs (or cotton tipped applicators to be accurate) so far.

I have had some days which have been pretty good. But if I am getting better it is slowly. I spent half of today lying down feeling as if my immune system was activated, those weird immune activation sensations down my spine and quite out of it.

A complication may be that I have sinus infection elsewhere in my sinuses. I have had blood in my phlegm when blowing my nose on occasions when the swabs came back clean. And I do feel infection up there in the frontal sinuses.

But the shear difficulty of dealing with this seemingly minor infection (moderate chronic infection according to the ENT) just shows how crap my immune system is a dealing with stuff.
 
Messages
21
@rosie26, I misspoke.

Per this article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3476754/#!po=82.9545, NALT (nasopharyngeal-associated lymphoreticular tissues) are only present until approximately 2 years of age in humans, and then disappear.

So then, my mistake, was thinking NALT might have been involved. But, since the girls would have likely been in their teens (or pre-teens), that would rule it out.

Mice retain their NALT. The article discusses experiments on mice with and without NALT, and the effectiveness of adjuvants.

I didn't realize that certain adjuvants activate the toll-like receptor 4 pathway. I skipped Protocol sections 1-5 why can't discussed the surgical methods (weak stomach!), but the rest of the article was informative.

@Richard7, thanks for the update, I was curious as to how things were going with your experiment.
 
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53
Treating Nasopharynx Inflammation With Zinc Chloride Cures 25% of ME/CFS Cases Triggered by HPV Vacci



In a 2016 Japanese study (full paper here), Dr Osamu Hotta et al looked at 41 patients who developed chronic fatigue syndrome (CFS) after receiving the human papillomavirus (HPV) vaccine.

All 41 patients were found to have severe chronic nasopharyngitis (also called epipharyngitis), which is an inflammation in the nasopharynx (also called the epipharynx), the area just above the pharynx.



The Nasopharynx
View attachment 19063

When the chronic inflammation in the nasopharynx area of 16 of these CFS patients was treated with 0.5% zinc chloride solution (ZnCI2) topically applied with cotton swabs, 25% of the 16 patients were completely cured of their CFS-like illness, and in total, 81% of the 16 patients significantly improved as a result of the treatment (they only treated 16 out of the 41 patients, because only these 16 were willing to regularly attend hospital for the zinc chloride treatment).

In the 19% of the 16 patients who did not respond to treatment, the study authors observed that the zinc chloride unfortunately did not reduce their nasopharygeal inflammation; whereas in the responders, they observed that the application of zinc chloride helped resolve the nasopharyngitis. So this is more evidence that the nasopharygeal inflammation is actually playing a causal role in these cases of CFS.


This study is very interesting, as it perhaps reignites the old idea of a chronic focal infection playing a role in ME/CFS (a focal infection is one that is localized to a specific site in the body). Several people on this forum had ME/CFS symptoms as a result of a chronic focal infection within the jaw bone (osteomyelitis). location

It also makes me wonder whether the chronic or recurrent sore throat (pharyngitis) and the crimson crescents often found in regular ME/CFS patients might be playing a role in driving the disease.


The Hotta 2016 study authors propose that the cures and symptomatic improvements in the CFS patients treated with zinc chloride could be related to hypothalamic pituitary adrenal (HPA) axis normalization, and propose that these improvement may arise from restoration of the immune neuroendocrine system.

The authors think that this nasopharyngitis treatment may also be effective for various other types of functional somatic syndrome, regardless of the initial cause, as well as for some autoimmune diseases. Functional somatic syndromes include: chronic fatigue syndrome, fibromyalgia, multiple chemical sensitivity, the Gulf War syndrome and irritable bowel syndrome.



Zinc Chloride Solution Treatment Applied to the Nasopharynx

The image below shows how the 0.5% zinc chloride solution is applied to the entire nasopharynx surface, by inserting cotton swabs through the nasal cavity, and by inserting cotton swabs via the back of the throat. The treatment procedure is shown at timecode 6:46 in this video.

Applying 0.5% Zinc Chloride Solution to the Inflamed Nasopharynx Using Swabs
View attachment 19071
The nasopharyngeal inflammation in the 41 patients with HPV vaccine-induced CFS was severe: when the 0.5% zinc chloride solution was dabbed onto the nasopharyngeal area with cotton swabs, the swabs were significantly reddened with blood from the inflamed nasopharyngeal tissues (see image below).

Diagnosis of nasopharyngitis can only be made by such direct surface abrasion using a cotton swab: if there is pain during surface abrasion and the cotton swab comes back with blood on it, then this helps confirm a diagnosis of nasopharyngitis.

As treatment continues over the weeks, the severity of the pain and the amount of blood on the swab is found to gradually reduce in response to treatment with zinc chloride.

The authors used the amount of blood found on the cotton swab as a rough gauge of the degree of nasopharyngeal inflammation (the more blood, the worse the inflammation).

Blood on the Cotton Swabs Used to Apply Zinc Chloride Solution to the Inflamed Nasopharynx
View attachment 19067

In the Hotta 2016 study, they found that all 41 patients with HPV vaccine-induced CFS had the 2+ severe level of bleeding on the cotton swab applicator, as shown at the far left of the above image, which indicated that they had severe chronic nasopharyngitis.

By contrast, in 39 female healthy controls, 39% had no bleeding, 56% had 1+ moderate to mild level bleeding, and 5% had the 2+ severe level bleeding, as determined by the amount of blood on the cotton swab. Ref: 1

So interestingly, in the general healthy population, 56% had mild to moderate nasopharyngitis.



Chronic Nasopharyngitis Links to Autoimmunity, HPA-Axis Dysfunction, Autonomic Nervous System Dysfunction, and Various Diseases

The authors think chronic nasopharyngitis (epipharyngitis) may play an important role in the development of autoimmune diseases. They say that because of its anatomical location, chronic inflammation in the nasopharynx could have systemic effects through autoimmunity, and also via the autonomic nervous system. More info can be found at timecode 13:27 of this video.

The Hotta 2016 study authors point out that:
  • Chronic nasopharyngitis is present in a significant proportion of the population.
  • Although it may cause significant symptoms, nasopharyngitis is rarely observed on routine otolaryngologic observation by ENT specialists.
  • Diagnosis of nasopharyngeal inflammation can only be made by direct surface abrasion of the nasopharyngeal mucous membrane (with a swab); pain during and after the abrasion of the nasopharyngeal mucosa with local hemorrhage confirms the presence of nasopharyngitis. In other words, if it hurts and it bleeds when a cotton swab is rubbed on your nasopharyngeal mucous membranes, then that indicates nasopharyngitis.
  • In the nasopharynx, there is an abundance of lymphocytes in the submucosal area, with a large number of lymphocytes colocating with the nasopharyngeal epithelial cells; there are more B-lymphocytes (B-cells) than T-lymphocytes (T-cells).
  • In the nasopharynx, both the T-lymphocytes and B-lymphocytes are highly activated, even in normal healthy individuals. So the nasopharynx site seems to be of immunological significance.
  • It is conceivable that latent, pre-existing inflammation of the nasopharynx may be prone to exacerbation by the immune stimulating effects of the adjuvants found in most vaccinations.
The Hotta 2016 study authors say that the various symptoms related to chronic nasopharyngitis can be divided into three categories:

(1) Direct or radiated symptoms caused by nasopharyngitis, including: headache, shoulder stiffness, neck stiffness, sore throat, throat discomfort including globus sensation (feeling of a lump in the throat that is not actually there), tinnitus, post-nasal drip, persistent cough, and low-grade fever are included in this category.

(2) The second category is symptoms that arise because of dysfunction of the hypothalamic-pituitary-adrenal axis (HPA axis) and alterations in the limbic system. Symptoms associated with dysfunction of the autonomic nervous system include: orthostatic dysregulation, dizziness, gastrointestinal symptoms, general fatigue, and generalized pain.

(3) The third category is an associated immune-mediated mechanism caused by focal inflammation of the nasopharynx, and symptoms or conditions associated with this include: glomerulonephritis / inflammation of the kidneys (such as immunoglobulin A nephropathy), dermatitis (such as chronic urticaria and pustulosis palmoplantaris), arthritis (such as reactive arthritis and sternocostoclavicular hyperostosis), and some other autoimmune diseases.


In Japan, the discovery of chronic nasopharyngitis, and the proposal that chronic nasopharyngitis could be linked to autoimmunity, originates with Professor Shinsaku Horiguchi 50 years ago (ref: 1). However, unfortunately the concept of chronic nasopharyngitis got lost in medicine, and was forgotten. Until now.



Further Info

An editorial commentary of the Dr Osamu Hotta 2016 study is found here: Is the immune neuroendocrine system the connection between epipharyngitis and chronic fatigue syndrome induced by HPV vaccine?

The Dr Osamu Hotta et al 2016 study is here (full paper here).

A good article about this study is found on the ME research UK website here.

Dr Osamu Hotta details his findings in this video presentation.


Professor Shinsaku Horiguchi's 1975 book: The Discovery of the Nasopharyngitis and Its Influence on General Diseases.





Link to Dr Shoemaker's Nasopharyngeal Infection With MARCoNS?

Dr Ritchie Shoemaker has found infections with multiple antibiotic-resistant coagulase-negative staphylococcus (MARCoNS) on the nasopharyngeal mucous membranes of patients with mold and biotoxin-induced illness (an illness Dr Shoemaker calls chronic inflammatory response syndrome, or CIRS).

Dr Shoemaker explains that this MARCoN infection of the nasopharynx is a major factor behind the pathogenesis of mold and biotoxin-induced illness:


When MARCoN bacteria are detected in a nasopharyngeal swab, Dr Shoemaker treats MARCoNS using the BEG nasal spray (two sprays 2 to 3 times a day, for 30 days). Ref: 1 The BEG nasal spray consists of Bactroban, EDTA and gentamicin.



Another possible parallel to the idea that chronic nasopharyngitis may be a causal factor in autoimmune disease is the link between jawbone cavitation osteonecrosis / infection and ME/CFS.


Wow. So much information. This site is a great resource. This post almost describes me perfectly (minus the HPV vaccine, being a male...but I DID have a flu vaccine slightly more than 72 hours pre-onset as well as some other issues).

Putting a swab into my right nasopharynx will often come out a bit bloody whereas my left never does.
I know this because sometimes I will use swabs to dab Vaseline up into the high nasal passages when they become irritated. Intense pain after exercise (rode a bike) in my right nasopharynx was my very first symptom...next day became a cold/flu followed by bronchitis (or possibly pneumonia...didn't go to the doctor because I was still invincible at that time) and then resolved into all this CFS nonsense.
I still get periodic intense flare ups in the right Nasopharynx and when this happens, it usually means things are about to go poorly for me for 2-3 days, but then sometimes "IT" also happens without the NP warning sign.
NP also is my weather advisory mechanism. My family thinks it is funny that I can tell by my naso symptoms that a sharp weather change is approaching.

I've also had altered sense of smell over the years. Sometimes it gets better sometimes worse. At is worst I can't smell sulfur. When it is better, then I smell things, but some specific things dont smell the way they should.
When disease first started I was extremely sensitive to cheap women's perfume (e.g. "old lady perfume")


TL;DR
I have bad nasopharynx either nerve or membrane irritation in my right NP since the beginning. Where can I get some 0.5 Zinc Chloride solution?





My first visit was to an ENT where I demanded a sinus CT because for the previous several months I couldn't breath like never before and was convinced I had a sinus infection. We did the CT and he was aggravated because it was what he called perfectly normal...I was also having white patches on the back of my tongue in the morning and aphthous ulcers had started during this time...none of which did he care about to note because I only had one bump during the visit and the whiteness on my tongue tended to improve during the course of the day vs the am.

A few years later I visited a much more pleasant ENT and all he could find was slightly deviated septum and a slightly enlarged nasal turbinate in one nostril and was more than willing to do some surgery (surgeons man, they love to cut). I asked him to what degree he thought the procedure might fix my breathing and I was not super impressed with his answer so i didn't do it. This surgery has a miserable recovery with frequent nose packings, sleeping in chairs, etc for several weeks during healing.

So, I've just been hooked on Afrin for many years now, because that is the absolute only thing that relieves my congestion and this congestion normally completely blocks my nasal passages during my sleep if I don't use Afrin. I've tried all the steroids and they do very little if anything....(Nasacort on a good day might help). Plus, there is no way somebody can convince me that by using nasal steroids morning and night, daily does not pump glucocorticoids into the brain at least to some degree. No thanks.
Sudafed helps a lot with the congestion, but I can't stand the heart palpitations if gives me at night and for some reason it can give me the sads...weird effect.
 

Hip

Senior Member
Messages
17,824
Where can I get some 0.5 Zinc Chloride solution?

I don't know, but if you could find some food grade zinc chloride, you could make a 0.5% solution by dissolving 0.5 of a gram of zinc chloride into 100 ml of water. ACS or USP designation chemicals are food grade.

It's possible some other form of zinc will work equally well, such as the zinc found in a zinc supplement.
 
Messages
53
I don't know, but if you could find some food grade zinc chloride, you could make a 0.5% solution by dissolving 0.5 of a gram of zinc chloride into 100 ml of water. ACS or USP designation chemicals are food grade.

It's possible some other form of zinc will work equally well, such as the zinc found in a zinc supplement.

Thanks, I'll check online for it. May not need it if this currently developing situation turns out to be something. I just had this amazing reaction with a high dose of Niacin where my passages are completely opened and my nose running for the first time since I don't know when. :)
 
Messages
53
I don't know, but if you could find some food grade zinc chloride, you could make a 0.5% solution by dissolving 0.5 of a gram of zinc chloride into 100 ml of water. ACS or USP designation chemicals are food grade.

It's possible some other form of zinc will work equally well, such as the zinc found in a zinc supplement.

The niacin is still having an interesting effect, but I'm intrigued about the zinc.

I am also impatient about finding Zinc Chloride.....so I will use my pill crusher on a zinc supplement I have for now (hopefully copper isn't bad for the nose since it is included). I happen to have a mg scale and a graduated cylinder at home, though I don't really expect the zinc to totally dissolve since it is wrapped in monomethionine so this will just be a rough experiment to see what happens and I may or may not build on it from there.

I've done a few nasopharyngeal swab collections on myself and other people as part of my job training so that part isn't a problem. We actually have a thing called NPG swabs intended for the purpose, but a Q-tip still works if you just go slow and when you meet resistance, simply try to gently change the angle of the swab and continue pushing gently upward and when you can go no further and when you feel like you've touched your brain, well, you've reached the nasopharynx. Really it is just all about maneuvering around the nasal turbinates on the way up and you get a feel for when you are getting close after doing it a couple of times.
If anybody has ever had a swab test for influenza this is similar, except in a clinic/hospital setting, nurses usually collect these and I've watched their techniques vary from barely sticking it in a patient's nose to something close to an icepick lobotomy.

OK, I just tried one. Apprx 70-75% of the standard size Q-tip is in my nose when I'm in my nasopharynx, but I think my nose is big so I don't know how useful that info is.

Pro tip: If anybody reads this in the future and has a really tight passageway a quick squirt of Afrin (Oxymetazoline HCl) up the nostril and waiting 5 to 10 minutes will widen the nasal passage quite a bit to make it easier to maneuver until you get a good feel for it.
 
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BadBadBear

Senior Member
Messages
571
Location
Rocky Mountains
I find this thread fascinating and have to wonder if the q tip procedure is also helpful as it would seem to be rather direct vagal nerve stimulation.

I have chronic sore throat and rhinitis isses, I am going to try Zicam nasal spray, and gargle of Listerine or zinc chloride wash and see how it goes. I know Listerine seems to help my sore throats, but never thought to use it for low level soreness.

I am not inclined to q tip as I am certain it will hurt and bleed.
 

Mel9

Senior Member
Messages
995
Location
NSW Australia
I have been following the procedure suggested by @Hip since March 2017 because of my constant rhinitis.

I don't go as far as I can (a bit nervous) but it really has helped. I ordered my zinc chloride through Plant Essentials, Queensland. I make a 0.5 perc, solution, (0.5g, around half of 1/8 teaspoon, in 100ml water in a screw-top jar) which I label clearly, with the warning 'POISON' and keep in the fridge.

I use it only when the insides of my nose is inflamed and I have problèms breathing in. This might be once per week or Fortnight. I get instant relief for a good long time.

It won't cure me but makes it a lot more comfortable and lets me get better sleep, especially when I use Clarantyne and Nasonex just before I go to bed. My husband likes it too because I have stopped snoring.
 

Hip

Senior Member
Messages
17,824
You may want to be a little cautious when experimenting using zinc in the nose: intranasal zinc products can sometimes cause a loss of smell. See this post.
 

Kathevans

Senior Member
Messages
689
Location
Boston, Massachusetts
I haven’t read this entire thread, but has anyone tried using a neti pot with a liquid solution? I’ve used one when I have a cold and need some relief, but have only used a standard saline solution that is recommended with the pot. And I think it’s also an Ayurvedic approach, which I like...

Maybe this is mentioned earlier!
 
Messages
7
Does anybody have an ingredient list and amount of each ingredient for the zinc chloride 0.5% solution? I am hoping to make this for my Wife to try. Thank you guys!
 

Hip

Senior Member
Messages
17,824
Does anybody have an ingredient list and amount of each ingredient for the zinc chloride 0.5% solution? I am hoping to make this for my Wife to try. Thank you guys!

The ingredients are just water and zinc chloride 0.5%. So for example if you have a small bottle containing 50 ml of water, which would weigh 50 grams, add 0.5% x 50 = 0.25 grams of zinc chloride.
 

Richard7

Senior Member
Messages
772
Location
Australia
To apply it I used 6" "sterile cotton tipped applicators" (they are like one ended long stemmed cotton buds) in my nose and jumbo swabs at the back of my throat.
 

sb4

Senior Member
Messages
1,654
Location
United Kingdom
@Hip What are the chances that pressure caused by the location of the inflammation of nasopharyngitis is pushing on the C1 / Clivus, or inflamming the ligaments around it causing CCI related issues?

Furthermore do you know of a poll done to see how many PWCFS onset was ENT infection. I think it is quite common is it not?
 

jstefl

Senior Member
Messages
250
Location
Brookfield, Wisconsin
I am wondering if anyone has been helped by Zinc Chloride?

I just found this thread, but the symptoms are very familiar to me. I have had a continuously sore throat and enlarged sinus cavities for as long as I can remember. All of my life I have made sure to carry a handkerchief with me wherever I go. This goes way back beyond my symptoms of ME/CFS.

For the last two or three years I was using Flonase every day in an attempt to keep the nasal passages clear. I had been waking up each morning with a stuffy nose and would see spots of blood on my handkerchief. After a couple of years on the Flonase, I began to have problems with the Flonase causing bleeding, so I switched to Xlear. The blood spots in the morning finally stopped appearing.

Several years ago I sought out a Ear Nose and Throat doctor to see if I could get some relief. I apparently picked an idiot, as his diagnosis was irritation caused by acid reflux. He has some pamphlets printed up showing how nasal problems were caused by acid reflux, and if you tilted your bed up -everything would get better. This apparently was hid advice for most of his patients. Instead of finding a better doctor, I gave up at that point.

After reading through this thread, I was motivated to get out my neti pot. I noticed that a good deal of blood was mixed with the ejected saline solution.

Reading this has motivated me to pursue this further. I am looking for advice as to how this can best be achieved.
 

Hip

Senior Member
Messages
17,824
@Hip What are the chances that pressure caused by the location of the inflammation of nasopharyngitis is pushing on the C1 / Clivus, or inflamming the ligaments around it causing CCI related issues?

I guess it is possible MMP connective tissue-destroying enzymes from the inflammation in the nasopharynx could cause a CCI.



Furthermore do you know of a poll done to see how many PWCFS onset was ENT infection. I think it is quite common is it not?

Chronic sore throat (pharyngitis) or recurrent sore throat is a common symptom of ME/CFS. But note here we are talking about nasopharyngitis, which is not the same thing as pharyngitis.

With nasopharyngitis you do not feel any soreness, so would not know that you have it, unless you specifically test for it.

I have the chronic sore throat symptom of ME/CFS (chronic pharyngitis), but in my test, I found I do not have nasopharyngitis. The technique for testing for chronic nasopharyngitis is given in this post.



I have had a continuously sore throat and enlarged sinus cavities for as long as I can remember.

Chronic sore throat (pharyngitis) is a common symptom of ME/CFS, but this is not the same thing as the chronic nasopharyngitis Dr Hotta is talking about.

You cannot normally see your nasopharynx area, because it is the area above the visible portion of the back of the throat region of your mouth.

Also, nasopharynx inflammation is painless and has no noticeable local symptoms. So with nasopharyngitis you do not feel any soreness, so would not know that you have it, unless you test for it.

So the way that Dr Hotta tests for a sore nasopharynx is by poking a cotton swab stick (Q-Tip) into the nasopharynx area, and rubbing it across this area, and if the cotton swab stick comes back with a lot of blood on it, then this is diagnostic for chronic nasopharyngitis (chronic inflammation of the nasopharynx area).

See this post for details on how to test for nasopharyngitis using a cotton swab stick.
 
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