[23M] With mouth sores, sneezing, and nasal congestion

Patient Description

A 23-year-old male is experiencing mouth sores, sneezing, and a stuffy nose. The sneezing occurs in bursts of three and started suddenly three days ago upon arriving at a resort in the Algarve region of Portugal. The patient reports a runny nose and post-nasal drip but denies itchy or watery eyes, coughing, or fever. There are three somewhat painful mouth sores present. The patient has not changed his diet or been exposed to known allergens and has not been in contact with anyone who is sick. The patient has a history of generalized anxiety disorder, diagnosed in 2017, and is treated with 15mg of escitalopram taken nightly. There are no known medication allergies, though there was a past adverse reaction to anesthesia.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, here are some possible explanations:

Mouth Sores

  • Canker Sores (Aphthous Ulcers): These are small, painful ulcers that can appear inside your mouth. They are not contagious and often resolve on their own within 1-2 weeks. Common triggers include stress, minor mouth injuries, acidic or spicy foods, and certain medical conditions.
  • Viral Infections: Sometimes, viral infections like the common cold or herpes simplex virus can cause mouth sores. Given that you are also experiencing sneezing and nasal congestion, a viral infection could be a unifying diagnosis.

Sneezing and Stuffy Nose

  • Allergic Rhinitis: This condition is caused by an allergic reaction to airborne substances like pollen, dust, or pet dander. Symptoms include sneezing, nasal congestion, runny nose, and post-nasal drip. Even if you haven't identified specific triggers, new environments can expose you to new allergens.
  • Viral Upper Respiratory Infection (Common Cold): This is a likely cause given your symptoms of sneezing, nasal congestion, runny nose, and post-nasal drip. Viral infections can also sometimes cause mouth sores.

What you can do

Mouth Sores

  • Avoid Irritants: Stay away from spicy, acidic, or rough-textured foods that can irritate your mouth sores.
  • Oral Hygiene: Maintain good oral hygiene by brushing your teeth gently and using a soft-bristled toothbrush.
  • Topical Treatments: Over-the-counter topical treatments like benzocaine (Orajel) can help numb the pain. Antiseptic mouthwashes can also help prevent infection.
  • Pain Relief: Over-the-counter pain relievers like ibuprofen or acetaminophen can help manage pain.

Sneezing and Stuffy Nose

  • Hydration: Drink plenty of fluids to stay hydrated and help thin mucus.
  • Nasal Irrigation: Use a saline nasal spray or a neti pot to rinse out your nasal passages.
  • Allergy Medications: Over-the-counter antihistamines like cetirizine (Zyrtec) or loratadine (Claritin) can help if allergies are suspected.
  • Rest: Ensure you get plenty of rest to help your body fight off any potential infection.

What you should look out for

While your symptoms are not immediately life-threatening, you should seek medical care if you experience any of the following:

  • Persistent or Worsening Symptoms: If your symptoms do not improve or worsen over the next few days, consult a healthcare provider.
  • High Fever: If you develop a high fever, it could indicate a more serious infection.
  • Difficulty Breathing: If you experience shortness of breath or difficulty breathing, seek medical attention immediately.
  • Severe Pain: If the pain from your mouth sores becomes unbearable or if you notice any signs of infection (e.g., increased redness, swelling, or pus), see a doctor.

Remember, while I can provide information and suggestions, it's important to consult with a healthcare professional for a formal diagnosis and treatment plan. You can use MDandMe to journal your symptoms, track your progress, get insights, and share your medical notes with your provider.

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4 mo ago


People Also Ask


What are common causes of mouth sores?

Common causes of mouth sores include canker sores (aphthous ulcers), viral infections like the common cold or herpes simplex virus, stress, minor mouth injuries, and certain foods that are acidic or spicy.


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

A common cold often includes symptoms like sneezing, nasal congestion, runny nose, and sometimes a sore throat or cough, and it is usually accompanied by a gradual onset. Allergic rhinitis, on the other hand, is characterized by sneezing, nasal congestion, runny nose, and post-nasal drip, often triggered by exposure to allergens and can occur suddenly.


What are some effective home remedies for relieving nasal congestion?

Effective home remedies for relieving nasal congestion include staying hydrated, using a saline nasal spray or neti pot for nasal irrigation, inhaling steam, and using a humidifier in your room. Over-the-counter decongestants and antihistamines can also be helpful.


When should I seek medical attention for mouth sores?

You should seek medical attention for mouth sores if they persist for more than two weeks, become increasingly painful, show signs of infection (such as increased redness, swelling, or pus), or if you experience difficulty eating or drinking due to the pain.

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