I am Dr. Shamoon. Reading your history carefully, I do not think you have two separate problems - the lump under the jaw, the left ear pain and the mucus sticking at the back of your throat are almost certainly one problem. A persistently inflamed throat/post-nasal drip drains into the jugulodigastric lymph node under the angle of the jaw, and the same Eustachian tube that opens into the back of the nose gets blocked, which is felt as left ear ache or fullness. So the lump is most likely a reactive lymph node, not something arising in the ear. At 26, a node that appeared with a throat infection, is soft-to-firm, mobile, mildly tender and under about 1.5-2 cm is reassuring. Importantly, a course of Clamp 625 will not shrink a reactive node quickly - nodes can take 3-6 weeks to settle even after the infection is gone, so "still present after antibiotics" does not mean treatment failure and does not by itself justify a second antibiotic course. What I would want ruled out is chronic allergic rhinitis with post-nasal drip (which keeps the whole cycle going), and, less commonly at your age, tuberculous or granulomatous nodes - which is why a node that is hard, matted, painless, steadily enlarging, or accompanied by evening fever, night sweats or weight loss should be biopsied rather than watched. Persistent one-sided ear pain with normal-looking ear also always deserves one ENT look with an otoscope and a nasal endoscopy, because referred ear pain can come from the throat base.
Next Steps
1) See an ENT specialist in person this week for otoscopy of the left ear, throat examination and a nasal endoscopy - one visit will tell you whether this is post-nasal drip with a reactive node or a true middle ear infection. 2) Do not start another antibiotic on your own; you have already completed Clamp 625, and repeating it will only upset your gut without shrinking the node. 3) Ask for an ultrasound of the neck (soft tissue) - it measures the node, shows its shape and blood flow, and reliably separates a reactive node from a suspicious one. Add a CBC with ESR; a Mantoux or chest X-ray only if the ENT doctor feels the node is not behaving like a reactive one. 4) For symptom relief meanwhile: steam inhalation twice a day, warm saline gargles 3-4 times a day, saline nasal spray, sleeping with the head slightly raised, and plenty of warm fluids. Paracetamol 500 mg when the ear pain is bad is enough - avoid repeated painkillers on an empty stomach. 5) Do not keep pressing or massaging the lump; frequent handling keeps it inflamed and makes it feel bigger. 6) Measure it once a week against a fixed reference (e.g. the edge of your fingernail) rather than daily. 7) If you would like me to go through your reports, your previous prescription and this ear-throat pattern together and tell you whether anything more is needed, you can book a consult with me here on Practo, or see me at Synergy Multispeciality Hospital, Miraj.
Health Tips
Get seen urgently if the lump becomes hard and fixed or crosses about 2 cm, if you develop fever with night sweats or weight loss, discharge or bleeding from the ear, sudden hearing loss, difficulty swallowing or opening the mouth, or swelling of the face and neck. A node that is still growing after 4-6 weeks needs a needle biopsy, not another antibiotic.