[27M] With persistent dry cough and morning eye discharge

Patient Description

A 27-year-old male presents with a persistent dry cough that has been ongoing for approximately 2 weeks. The cough is described as moderate in severity at night and mild during the day, worsening when lying down and with physical activity. The patient also experiences difficulty swallowing and dry mouth, particularly at night, requiring water intake to alleviate discomfort. Additionally, the patient reports waking up with clear eye discharge that 'welds' the right eye shut, occurring three times in the past two weeks. The discharge is relieved with the use of eye drops. There is no associated fever or chills, and the cough sometimes produces mucus or phlegm.

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Arora's Assessment

What might be happening

Based on the information you provided, your symptoms may be due to:

  • Postnasal Drip: This condition occurs when excess mucus from your nose drips down the back of your throat. This can lead to a persistent cough, especially at night when you're lying down, and a dry throat.

    • Treatment typically involves addressing the underlying cause, such as allergies or a sinus infection. Over-the-counter decongestants and antihistamines may also help.
  • Gastroesophageal Reflux Disease (GERD): This is a condition where stomach acid frequently flows back into your esophagus (the tube connecting your mouth and stomach). This can irritate your throat and cause a persistent cough, especially at night when you're lying down.

    • Treatment typically involves lifestyle changes and over-the-counter medications. Prescription medications and surgery may be necessary in severe cases.
  • Viral Conjunctivitis: This is an inflammation of the conjunctiva, the thin clear tissue that lies over the white part of the eye and lines the inside of the eyelid. It's often referred to as "pink eye" and can cause eye discharge.

    • Treatment typically involves supportive care, such as applying a warm compress to your eyes and using over-the-counter eye drops. Antibiotics are not typically necessary as this condition is usually caused by a virus.

What you can do

While you should seek care from a healthcare professional for a formal diagnosis and treatment, here are some things you can do in the meantime:

  1. Try to elevate your head while sleeping to help reduce postnasal drip and GERD symptoms.
  2. Avoid eating large meals or eating close to bedtime to help reduce GERD symptoms.
  3. Use over-the-counter decongestants and antihistamines to help reduce postnasal drip symptoms.
  4. Apply a warm compress to your eyes and continue using over-the-counter eye drops to help reduce viral conjunctivitis symptoms.

What you should look out for

You should seek immediate medical attention if you experience any of the following:

  • Difficulty breathing or shortness of breath
  • Chest pain
  • High fever (temperature over 100.4°F)
  • Symptoms that worsen or do not improve after a week
  • Severe eye pain or changes in vision

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, diagnosis, and treatment.

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9 mo ago


People Also Ask


What are common causes of a persistent dry cough that worsens at night?

Common causes of a persistent dry cough that worsens at night include postnasal drip, gastroesophageal reflux disease (GERD), asthma, and certain medications. It's important to identify the underlying cause to determine the appropriate treatment.


How can postnasal drip lead to a persistent cough?

Postnasal drip occurs when excess mucus from the nose drips down the back of the throat, irritating it and causing a cough. This is often more noticeable at night when lying down. Treatment may involve addressing allergies or sinus infections, and using decongestants or antihistamines.


What are the symptoms and treatment options for viral conjunctivitis?

Viral conjunctivitis, also known as pink eye, is characterized by redness, itching, and discharge from the eyes. It is usually caused by a virus and does not require antibiotics. Treatment focuses on relieving symptoms with warm compresses and over-the-counter eye drops.


How does GERD contribute to nighttime coughing and what lifestyle changes can help?

GERD can cause stomach acid to flow back into the esophagus, irritating the throat and leading to a cough, especially at night. Lifestyle changes such as elevating the head while sleeping, avoiding large meals before bedtime, and reducing acidic foods can help manage symptoms.

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