[22F] With sore throat, fever, and gastrointestinal symptoms

Patient Description

A 22-year-old female presents with a sore throat that has been gradually worsening over the past day and a half, with sudden increases in discomfort. The sore throat is accompanied by swelling, difficulty swallowing, and hoarseness. Cold water provides some relief. The patient also reports experiencing fever, coldness, strong hunger or nausea, drowsiness, cough, and nasal congestion. She has a history of minor immunodeficiency diagnosed 12 years ago and shows signs of lupus, though no official diagnosis has been made. There is a family history of lupus and Ehlers-Danlos syndrome. The patient denies smoking or using tobacco products and is fully vaccinated. No current medications or known drug allergies are reported.

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Arora's Assessment

What might be happening

Based on your symptoms, here are some possible explanations:

  1. Viral or Bacterial Infection: Your sore throat, fever, and nasal congestion could be due to a viral infection like the common cold or flu. Bacterial infections, such as strep throat, are also possible, especially with throat swelling and difficulty swallowing. These infections often cause symptoms like fever, sore throat, and general malaise.

  2. Gastroesophageal Reflux Disease (GERD): Although you haven't experienced heartburn, your sore throat and nausea could be related to acid reflux, where stomach acid irritates the throat. This is less likely given your symptoms but still a possibility.

  3. Autoimmune Flare: Given your family history and signs of lupus, an autoimmune flare could contribute to your symptoms, particularly the sore throat and fever. Autoimmune conditions can cause systemic symptoms like fatigue and fever.

  4. Minor Immunodeficiency: Your immunodeficiency might make you more susceptible to infections, which could explain the severity of your symptoms.

Typical treatments or testing might include a throat swab to check for strep throat, blood tests to assess for infection or autoimmune activity, and possibly imaging if symptoms persist or worsen.

What you can do

Sore Throat and Fever:

  • Stay Hydrated: Drink plenty of fluids, like water or herbal teas, to soothe your throat and stay hydrated.
  • Rest: Ensure you get plenty of rest to help your body fight off any infection.
  • Over-the-Counter Relief: Consider using throat lozenges or over-the-counter pain relievers like acetaminophen or ibuprofen to manage pain and fever. Follow dosing instructions carefully.

Nausea and Drowsiness:

  • Small, Frequent Meals: Eat small, bland meals to help manage nausea. Foods like crackers or toast can be easier on the stomach.
  • Avoid Triggers: Identify and avoid foods or activities that worsen your nausea.

Coldness and Congestion:

  • Warmth: Keep warm with layers of clothing or blankets to help with the feeling of coldness.
  • Steam Inhalation: Use a humidifier or inhale steam from a bowl of hot water to relieve nasal congestion.

General Advice:

  • Monitor Symptoms: Keep track of your symptoms using MDandMe to journal your symptoms, track progress, and share insights with your healthcare provider.
  • Seek Medical Attention: If symptoms worsen or do not improve, consult a healthcare professional for further evaluation.

What you should look out for

Seek medical care if you experience any of the following:

  • Severe Throat Pain: If your throat pain becomes severe or you have difficulty breathing or swallowing.
  • High Fever: A persistent high fever that does not respond to over-the-counter medications.
  • Worsening Symptoms: Any new or worsening symptoms, such as rash, joint pain, or severe fatigue, especially given your family history of autoimmune conditions.

Remember, while I can provide information and suggestions, it's important to consult with a healthcare professional for a formal diagnosis and treatment plan.

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People Also Ask


What are the common symptoms of a viral or bacterial throat infection?

Common symptoms of a viral or bacterial throat infection include sore throat, fever, swollen glands, difficulty swallowing, and sometimes hoarseness. Bacterial infections like strep throat may also cause white patches on the tonsils.


How can minor immunodeficiency affect susceptibility to infections?

Minor immunodeficiency can make an individual more susceptible to infections because the immune system is not as effective at fighting off pathogens. This can lead to more frequent or severe infections compared to individuals with a normal immune system.


What are the signs of an autoimmune flare, particularly related to lupus?

Signs of an autoimmune flare, especially in lupus, can include fever, joint pain, fatigue, skin rashes, and swollen lymph nodes. These symptoms occur because the immune system mistakenly attacks the body's own tissues.


What home remedies can help alleviate sore throat and nasal congestion?

Home remedies for sore throat and nasal congestion include staying hydrated with warm fluids, using throat lozenges, inhaling steam, using a humidifier, and resting. Over-the-counter pain relievers can also help manage symptoms.


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