[20F] Experiencing upper respiratory symptoms with severe headache

Patient Description

A 20-year-old female presents with symptoms starting yesterday, including ear aches, nasal congestion with clear to greenish drainage, sore throat, runny nose, and moderate throat and ear drainage. She also experiences a dull chest ache rated 6/10 in severity when breathing deeply, starting today. Additionally, the patient reports a severe headache and slight neck stiffness. The congestion worsens at night and in the morning. No fever, rash, or sensitivity to light noted. The patient is currently on a 5-day course of azithromycin prescribed for possible strep throat, and takes Vyvanse (50 mg, 8 months) and Wellbutrin (300 mg daily). No known allergies or pre-existing conditions reported.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, you might be experiencing:

  • Common Cold: This is a viral infection that primarily affects your nose and throat. It's usually harmless and symptoms improve within a week to 10 days. Your symptoms of a runny nose, congestion, sore throat, and headache are common symptoms of a cold.

  • Sinusitis: This is an inflammation or swelling of the tissue lining the sinuses. It can be caused by a common cold, allergic rhinitis, nasal polyps, or a deviated septum. Your symptoms of nasal congestion, runny nose, and facial pain/pressure are common symptoms of sinusitis.

  • Influenza (Flu): This is a viral infection that attacks your respiratory system — your nose, throat and lungs. Influenza is commonly called the flu, but it's not the same as stomach "flu" viruses that cause diarrhea and vomiting. Your symptoms of a runny nose, congestion, sore throat, and headache, along with the sudden onset, could indicate the flu.

  • Strep Throat: This is a bacterial infection that can make your throat feel sore and scratchy. Strep throat accounts for only a small portion of sore throats. Your recent prescription of azithromycin for possible strep throat could be treating this.

Please note that this is not an exhaustive list of all possible conditions, and having these symptoms does not necessarily mean you have any of these conditions. It's important to consult with a healthcare provider for an accurate diagnosis.

What you can do

  1. Continue taking your prescribed medication, including the azithromycin, as directed by your healthcare provider.
  2. Rest and hydrate. These are two of the most important things you can do to help your body recover from a viral or bacterial infection.
  3. Over-the-counter medication can help with symptom relief. For example, acetaminophen (Tylenol) can help with pain and fever, and decongestants can help with nasal congestion.
  4. Gargling with warm salt water can help soothe a sore throat.
  5. Using a humidifier can help keep your throat and nasal passages moist and relieve congestion.

What you should look out for

You should seek immediate medical attention if you experience:

  • Difficulty breathing or shortness of breath
  • Severe or persistent vomiting
  • Symptoms that last more than a week
  • Severe headache or neck stiffness
  • Any other severe or concerning symptoms

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

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10 mo ago

People Also Ask


What are the common symptoms of a sinus infection?

Common symptoms of a sinus infection include nasal congestion, thick nasal discharge, facial pain or pressure, reduced sense of smell, and sometimes fever. Symptoms can overlap with those of a cold, but sinusitis often lasts longer and may require medical treatment.


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

The common cold and the flu share symptoms like a runny nose, sore throat, and congestion. However, the flu often comes on suddenly and is more likely to include high fever, body aches, fatigue, and chills. The flu can also lead to more serious complications.


What are the potential side effects of taking azithromycin?

Azithromycin can cause side effects such as nausea, vomiting, diarrhea, stomach pain, and headache. More serious side effects are rare but can include allergic reactions, liver problems, and heart rhythm changes. It's important to contact a healthcare provider if severe side effects occur.


When should I seek medical attention for a sore throat?

You should seek medical attention for a sore throat if it is severe, lasts more than a week, is accompanied by difficulty breathing or swallowing, or if you have a high fever. Persistent or worsening symptoms may indicate a more serious condition that requires medical evaluation.


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