[18M] Experiencing lightheadedness, ear pressure, and cough with congestion

Patient Description

An 18-year-old male reports moderate lightheadedness, rated 7/10, that resolves quickly upon lying down, and has been ongoing for 2 days. He also experiences moderate cough with phlegm and a sensation of fullness or pressure in the ears, without any recent cold or flu. The patient has taken a one-time dose of 200mg Ibuprofen. There is no history of recent head injury, air pressure changes, or substance use. The patient does not have a history of allergies, adverse medication reactions, pre-existing conditions, or chronic illnesses. He also notes light headache and tenderness on the left side of the neck, which may be related to his sleeping position.

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Arora's Assessment

What might be happening

Based on the information you've provided, here are some possible explanations for your symptoms:

  • Common Cold or Upper Respiratory Tract Infection: This is a viral infection that affects your nose and throat. Symptoms can include a cough, congestion, and a mild headache. The pressure in your ears could be due to congestion in your upper respiratory tract. Over-the-counter cold remedies and rest are usually sufficient treatment.
  • Influenza (Flu): This is a more severe viral infection that can cause fever, chills, cough, and body aches. If your fever and chills were significant, this could be a possibility. Antiviral medications can help if started early in the illness.
  • Orthostatic Hypotension: This is a form of low blood pressure that happens when you stand up from sitting or lying down, and can cause dizziness and lightheadedness. It's usually managed by making certain changes in your lifestyle, such as drinking plenty of fluids and standing up slowly.
  • Sinusitis: This is an infection or inflammation of the sinuses, often caused by a virus. Symptoms can include a headache, pressure in the ears, cough, and nasal congestion. Treatment usually involves rest, hydration, and over-the-counter remedies.

What you can do

  • Rest and Hydrate: Make sure you're getting plenty of sleep and drinking lots of fluids. This can help your body recover from a viral infection and can also help manage symptoms of orthostatic hypotension.
  • Over-the-Counter Remedies: Over-the-counter cold remedies can help with symptoms of a cold or sinusitis. For your cough, look for a cough suppressant (antitussive) or expectorant.
  • Slow Position Changes: If you're experiencing orthostatic hypotension, try changing positions more slowly. This can help your body adjust to the change in blood pressure more gradually.

What you should look out for

  • Persistent or Worsening Symptoms: If your symptoms persist for more than a week, or if they get worse, you should seek medical attention.
  • Severe Headache or Stiff Neck: These could be signs of a more serious condition, such as meningitis, and you should seek medical attention immediately.
  • Difficulty Breathing: If you have trouble breathing, seek medical attention immediately.

Please remember that while I strive to provide accurate and helpful information, I'm not a doctor. You should seek care from a healthcare professional for a formal diagnosis and treatment.

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9 mo ago


People Also Ask


What causes lightheadedness that resolves upon lying down?

Lightheadedness that resolves upon lying down can be caused by orthostatic hypotension, which is a drop in blood pressure when standing up. It can also be due to dehydration or other factors affecting blood circulation.


Can a sensation of fullness in the ears be related to a respiratory infection?

Yes, a sensation of fullness in the ears can be related to a respiratory infection, such as a cold or sinusitis, due to congestion and pressure changes in the Eustachian tubes.


What are some common treatments for a cough with phlegm?

Common treatments for a cough with phlegm include staying hydrated, using over-the-counter expectorants to help clear mucus, and using a humidifier to keep air moist. Rest and avoiding irritants like smoke can also help.


How can I differentiate between a common cold and the flu?

The common cold usually presents with milder symptoms such as a runny nose, sore throat, and mild cough, while the flu often includes more severe symptoms like high fever, body aches, and fatigue. A healthcare provider can help differentiate between the two based on symptoms and possibly testing.

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