[32M] Experiencing chronic flu-like symptoms with ENT involvement

Patient Description

A 32-year-old male reports suffering from widespread body and muscle aches, chronic stuffy nose, pressure headaches, earaches, and a sore throat with a sensation of drainage since July of the previous year. The sore throat is somewhat alleviated by cough drops, and the headaches, which are described as a pressure feeling in the middle of the forehead, worsen with exertion. The patient also experiences hoarseness, frequent throat clearing, and night sweats. There is facial pain and pressure, particularly between the eyes, and a somewhat hindered sense of smell. Symptoms exacerbate after exposure to allergens such as dust, pollen, or animal dander. Nasal discharge is occasionally green but predominantly dry. The patient's last blood work indicated high Epstein-Barr virus (EBV) titers. The patient takes non-prescription supplements, including vitamins C and D, magnesium, and zinc, and does not report any known allergies or adverse reactions to medications. No prescription medications or over-the-counter drugs are being taken, except for ibuprofen as needed.

Arora's Assessment

What might be happening

Based on the symptoms you've described, there are several possibilities:

Chronic Sinusitis: This condition is characterized by inflammation of the sinuses lasting longer than 12 weeks. Symptoms can include nasal congestion, green nasal discharge, facial pain or pressure, reduced sense of smell, and fatigue. The fact that your symptoms worsen with exposure to certain substances suggests that allergies may be contributing to your condition.
- Treatment typically involves managing symptoms with over-the-counter remedies, nasal irrigation, and sometimes antibiotics or corticosteroids. If allergies are contributing, antihistamines or allergy shots may be recommended.
Post-Viral Syndrome: This can occur after a viral infection, such as Epstein-Barr virus (EBV), which you mentioned was detected in high numbers in your blood work. Symptoms can include fatigue, muscle aches, and flu-like symptoms.
- Treatment typically involves rest, a healthy diet, and over-the-counter remedies to manage symptoms. If symptoms persist, antiviral medication may be prescribed.
Fibromyalgia: This is a disorder characterized by widespread musculoskeletal pain, fatigue, and tenderness in localized areas. It's often associated with other symptoms like sleep, memory and mood issues.
- Treatment often involves a combination of medications, exercise, stress management techniques, and healthy lifestyle habits.

What you can do

Continue to manage your symptoms with over-the-counter remedies like ibuprofen and cough drops.
Try using a humidifier in your home to help with your nasal congestion and sore throat.
Rest and maintain a healthy diet to help your body recover.
Avoid known allergens and irritants as much as possible.
Keep a symptom diary to track any changes or patterns in your symptoms. This can be helpful information to share with your doctor.

What you should look out for

Please seek immediate medical attention if you experience:

Severe headache or a headache that is different from your usual headaches
Difficulty breathing or shortness of breath
High fever (temperature over 100.4°F)
Symptoms that are worsening or not improving despite self-care measures

Please remember that while I strive to provide accurate information, I'm not a doctor and this advice should not replace a consultation with a healthcare professional.

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11 mo ago

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