[24F] With sore throat and facial swelling

Patient Description

A 24-year-old female presents with a sore throat that began approximately three days ago. The pain is significant when swallowing, and there is notable swelling of the lymph nodes and the entire bottom of the face, extending to the teeth and gums. The gums are swollen, puffy, and bleed upon brushing. The patient reports feeling hot to the touch, suggesting a possible fever, although no temperature has been recorded. Additional symptoms include headaches, difficulty sleeping, nasal congestion, and a runny nose. There is no cough, ear pain, or changes in voice. The patient recently started taking hydroxyzine 25mg daily, about seven days ago, prior to the onset of symptoms. Medical history includes endometriosis diagnosed in the summer of 2024, chronic migraines, anxiety, and depression, all diagnosed over a decade ago. Current medications include hydroxyzine 25mg daily, Seroquel 150mg daily, propranolol 10mg three times a day, and omeprazole. The patient has allergies to penicillin and cephalosporins.

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Arora's Assessment

What might be happening

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

  • Viral Pharyngitis: This is a common cause of sore throat and can be accompanied by swollen lymph nodes, nasal congestion, and runny nose. Viral infections often resolve on their own, but they can cause significant discomfort in the meantime.

    • Typical treatment involves rest, hydration, and over-the-counter pain relievers to manage symptoms.

  • Bacterial Infection (e.g., Strep Throat): Although you have an allergy to penicillin and cephalosporins, it's important to consider bacterial infections like strep throat, which can cause a sore throat, swollen lymph nodes, and fever. A healthcare provider can perform a rapid strep test or throat culture to confirm this.

    • Treatment usually involves antibiotics, but alternatives to penicillin and cephalosporins are available for those with allergies.

  • Dental or Gum Infection: The swelling and tenderness in your gums and teeth could indicate a dental issue, such as gingivitis or a dental abscess, which can sometimes cause referred pain to the throat.

    • Treatment may involve dental cleaning, antibiotics, or other dental procedures.

What you can do

While it's important to consult a healthcare provider for a formal diagnosis and treatment, here are some steps you can take to alleviate your symptoms:

  1. Stay Hydrated: Drink plenty of fluids, such as water, herbal teas, or broths, to keep your throat moist and help reduce swelling.
  2. Gargle with Salt Water: This can help soothe a sore throat and reduce inflammation.
  3. Use a Humidifier: Adding moisture to the air can help ease throat discomfort and congestion.
  4. Over-the-Counter Pain Relief: Consider using acetaminophen or ibuprofen to manage pain and reduce fever.
  5. Monitor Your Symptoms: Use MDandMe to journal your symptoms, track your progress, and share this information with your healthcare provider.

What you should look out for

Seek medical attention if you experience any of the following:

  • Difficulty breathing or swallowing
  • High fever or persistent fever
  • Severe pain or swelling that worsens
  • Signs of a dental abscess, such as severe toothache or swelling in the jaw
  • If your symptoms do not improve or worsen over time

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

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2 mo ago

People Also Ask

What are the common causes of a sore throat with swollen lymph nodes?

Common causes of a sore throat with swollen lymph nodes include viral infections like the common cold or flu, bacterial infections such as strep throat, and sometimes dental or gum infections. Allergies and irritants can also cause similar symptoms.

How can I differentiate between a viral and bacterial throat infection?

Viral infections often come with symptoms like a runny nose, cough, and mild fever, and they usually resolve on their own. Bacterial infections like strep throat may cause more severe symptoms, such as a high fever, white patches on the tonsils, and swollen lymph nodes. A rapid strep test or throat culture can help differentiate between the two.

What are the signs of a dental or gum infection that could cause throat pain?

Signs of a dental or gum infection include swollen, red, or bleeding gums, persistent bad breath, pain in the teeth or gums, and sometimes swelling in the jaw or face. A dental abscess may cause severe pain and swelling.

What should I do if I have a penicillin allergy and need antibiotics for a bacterial infection?

If you have a penicillin allergy and need antibiotics, your healthcare provider can prescribe alternative antibiotics such as macrolides (e.g., azithromycin) or clindamycin, which are effective for treating bacterial infections like strep throat.

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