[20F] Experiencing respiratory and nasal symptoms

Patient Description

A 20-year-old female has been experiencing nasal congestion that fluctuates in severity, often worsening at night, for the past 2 months. The nasal discharge has transitioned from green to clear with a light brown tinge, accompanied by a metallic taste. She reports chest pressure and wheezing when coughing up mucus and has episodes of shortness of breath and airway tightening. While she does not have a known history of asthma or allergies beyond seasonal symptoms, she has been taking allergy pills to manage her symptoms. No fever, chills, or known medication allergies are reported, and she is not currently on any other medications.

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Arora's Assessment

What might be happening

Based on your symptoms, the following conditions could be possible:

  • Chronic Rhinosinusitis: This is a common condition characterized by inflammation of the nasal and sinus passages. Symptoms can include nasal congestion, runny nose with clear to light brown discharge, facial pain or pressure, and a reduced sense of smell. The metallic taste you're experiencing could be due to postnasal drip associated with this condition.

    • Treatment typically includes nasal corticosteroids, saline nasal irrigation, and sometimes antibiotics or oral corticosteroids.
  • Asthma: This is a condition that causes your airways to become inflamed and narrow, and it can produce extra mucus. This can make breathing difficult and trigger coughing, wheezing, and shortness of breath. Asthma can be triggered by various factors, including allergies.

    • Treatment typically includes inhaled corticosteroids and long-acting beta agonists, and quick-relief inhalers for flare-ups.
  • Allergic Rhinitis: This is an allergic response to allergens like dust, pollen, or pet dander. Symptoms can include runny or stuffy nose, sneezing, and coughing.

    • Treatment typically includes antihistamines, decongestants, and nasal corticosteroids.

Please note that these are only possible diagnoses. You should consult with a healthcare professional for an accurate diagnosis.

What you can do

Here are some general suggestions that might help with your symptoms:

  1. Continue taking your non-drowsy Claritin liquid gels as directed by the package instructions or your healthcare provider.
  2. Use a humidifier in your bedroom at night to help keep your nasal and throat passages moist.
  3. Stay hydrated by drinking plenty of fluids. This can help thin the mucus in your nasal passages and may relieve congestion.
  4. Avoid known allergens as much as possible.
  5. Over-the-counter saline nasal spray can help clear your nasal passages.

What you should look out for

Please seek immediate medical attention if you experience:

  • Difficulty breathing or shortness of breath that is getting worse
  • Chest pain or pressure that is severe or lasts longer than a few minutes
  • Coughing up blood or bloody mucus
  • High fever (temperature over 100.4°F)
  • Symptoms that persist despite treatment or that are getting worse

Remember, this advice is intended to be general in nature, and specific causes may need different approaches. Always consult with a healthcare professional for accurate information.

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9 mo ago


People Also Ask


What could cause nasal congestion to worsen at night?

Nasal congestion can worsen at night due to lying down, which can increase blood flow to the nasal passages, causing them to swell. Additionally, allergens in the bedroom, such as dust mites, can exacerbate symptoms.


Why might someone experience a metallic taste with nasal congestion?

A metallic taste can occur due to postnasal drip, where mucus from the nasal passages drips down the throat, carrying with it various substances that can alter taste perception.


What are the common symptoms of asthma that I should be aware of?

Common symptoms of asthma include wheezing, shortness of breath, chest tightness, and coughing, especially at night or early in the morning. These symptoms can be triggered by exercise, allergens, or respiratory infections.


How can I differentiate between allergic rhinitis and a common cold?

Allergic rhinitis is typically characterized by itchy eyes, sneezing, and a runny or stuffy nose, often in response to allergens. A common cold may include similar symptoms but is usually accompanied by a sore throat, body aches, and sometimes a fever, and it is caused by a viral infection.

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