[25F] Experiencing nasal scabbing, congestion, and bloody mucus

Patient Description

A 25-year-old female presents with a 5-day history of nasal scabbing on the cartilage with associated bleeding and a white patch. She reports a blocked right nostril, thick and rubbery clear nasal discharge that turns grey and bloody when expectorated. The patient also notes a new onset of sore throat. She confirms moderate amounts of grey or bloody mucus and increased fatigue. The symptoms worsen when lying down or after sniffing drugs. She has a history of gastrointestinal issues diagnosed a year ago, no known drug allergies, and is not currently on any medications.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, possible causes include:

  • Sinusitis: This is an inflammation or swelling of the tissue lining the sinuses. It's often caused by a viral infection and persists even after other upper respiratory symptoms are gone. In some cases, fungi or bacteria may cause sinusitis, and it can also occur as a result of allergies, tooth infections, or nasal polyps. The symptoms typically include a runny or stuffy nose, facial pain or pressure, and postnasal drip, which can lead to a sore throat.

    • Treatment usually involves self-care measures such as rest, hydration, and over-the-counter remedies. If bacteria are the cause, your doctor may prescribe antibiotics. In cases of chronic sinusitis, further treatments such as nasal corticosteroids or surgery may be needed.
  • Rhinitis: This is inflammation and swelling of the mucous membrane in the nose, characterized by a runny nose, itching, and sneezing. It can be allergic (caused by allergens such as dust mites, pet dander, or pollen) or non-allergic (caused by infections, certain medications, or substances such as smoke or perfume).

    • Treatment typically involves avoiding the cause of the inflammation, if known, and may include medications such as antihistamines or nasal sprays.
  • Nasal polyps: These are soft, painless, noncancerous growths on the lining of your nasal passages or sinuses. They can lead to a blocked nose and runny nose. They may also cause other symptoms, such as reduced sense of smell, facial pain, and postnasal drip.

    • Treatment usually involves medication to reduce the size of the polyps or surgery to remove them.

Please note that the presence of blood in your mucus and the scabbing in your nose are concerning symptoms that should be evaluated by a healthcare professional as soon as possible.

What you can do

  1. Seek medical attention: Given the duration and nature of your symptoms, it's important to seek medical attention. A healthcare professional can provide a proper diagnosis and appropriate treatment.

  2. Over-the-counter remedies: Over-the-counter nasal sprays or saline rinses may help with your nasal symptoms in the meantime.

  3. Hydration: Drink plenty of fluids to help thin your mucus and soothe your sore throat.

  4. Rest: Make sure you're getting enough sleep to help your body fight off any potential infection.

What you should look out for

Please seek immediate medical attention if you experience:

  • Difficulty breathing
  • Severe headache or facial pain
  • High fever
  • Symptoms that persist or worsen despite treatment

Remember, this advice is intended to be general in nature, and specific causes may not apply to your situation. Always consult with a healthcare provider for appropriate examination, testing, and care.

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1 yr ago

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People Also Ask


What causes nasal scabbing and bleeding?

Nasal scabbing and bleeding can be caused by dry air, frequent nose picking, infections, or trauma to the nasal passages. In some cases, it may also be due to underlying conditions such as sinusitis or rhinitis.


How can sinusitis lead to a sore throat?

Sinusitis can lead to a sore throat due to postnasal drip, where mucus from the sinuses drains down the back of the throat, causing irritation and soreness.


What are the potential risks of untreated nasal polyps?

Untreated nasal polyps can lead to chronic sinus infections, breathing difficulties, and a reduced sense of smell. In severe cases, they can obstruct nasal passages and require surgical intervention.


How can drug use affect nasal health?

Drug use, particularly inhaled substances, can damage the nasal lining, leading to inflammation, scabbing, and increased risk of infections. It can also exacerbate existing nasal conditions like rhinitis or sinusitis.


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