[35F] Experiencing severe nasal congestion, nausea, vomiting, and migraines

Patient Description

A 35-year-old female presents with severe nasal congestion that has persisted for a week, rendering her unable to breathe through her nose and accompanied by green discharge. She has been experiencing nausea for three days, rating the severity as 8 out of 10, and vomiting three times in one day, triggered by attempts to eat or drink. She also reports a pounding headache on the side of her head, with an intensity of 7 out of 10, worsening after blowing her nose, and a history of regular migraines since age 12. The patient experiences sensitivity to light and occasional chills at night but no fever, altered mental status, or difficulty staying awake. She has been on Junel Fe birth control for almost a year and takes Olly vitamins for vitamin C, D, and A daily. No known allergies, pre-existing conditions, or other medications were reported.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, here are a few possibilities:

  • Common Cold or Upper Respiratory Tract Infection: This is often characterized by a stuffy or runny nose, sore throat, cough, congestion, body aches, headache, and sometimes vomiting due to post-nasal drip. It's usually caused by a viral infection.

    • Treatment typically involves rest, hydration, and over-the-counter remedies to manage symptoms. Antibiotics are not effective against viral infections.
  • Sinusitis: This is an inflammation or swelling of the tissue lining the sinuses, often caused by a viral or bacterial infection. Symptoms can include headache, nasal congestion, thick nasal mucus, a sore throat, and sometimes nausea or vomiting.

    • Treatment can include nasal decongestants, pain relievers, and in some cases, antibiotics if a bacterial infection is suspected.
  • Migraine: You mentioned a history of migraines, and your current headache could be a migraine attack. Migraines can sometimes be accompanied by nausea and sensitivity to light.

    • Treatment typically involves rest, avoiding triggers, and taking prescribed or over-the-counter migraine medication.

What you can do

  1. Rest and hydrate: This can help your body recover if you're dealing with a cold or sinusitis.
  2. Over-the-counter remedies: Decongestants, pain relievers, and cough suppressants can help manage your symptoms.
  3. Avoid triggers: If your headache is a migraine, try to avoid any known triggers and take your usual migraine medication if you have it.
  4. Seek medical attention: If your symptoms persist or worsen, or if you develop new symptoms such as a high fever, severe headache, chest pain, or difficulty breathing, seek medical attention immediately.

What you should look out for

  • High fever (temperature over 100.4°F)
  • Severe headache
  • Chest pain
  • Difficulty breathing
  • Symptoms persisting for more than a week or worsening

Please remember that 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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10 mo ago

People Also Ask


What are the common symptoms of sinusitis and how is it treated?

Common symptoms of sinusitis include headache, nasal congestion, thick nasal mucus, sore throat, and sometimes nausea or vomiting. Treatment can involve nasal decongestants, pain relievers, and antibiotics if a bacterial infection is suspected.


Can migraines cause nausea and sensitivity to light?

Yes, migraines can cause nausea and sensitivity to light. These are common symptoms that accompany the headache during a migraine attack.


When should I seek medical attention for a headache?

You should seek medical attention for a headache if it is severe, accompanied by a high fever, chest pain, difficulty breathing, or if it persists or worsens over time.


How can I differentiate between a common cold and a sinus infection?

A common cold typically involves a runny or stuffy nose, sore throat, and cough, while a sinus infection (sinusitis) often includes thicker nasal discharge, facial pain or pressure, and a longer duration of symptoms. If symptoms persist for more than a week or are severe, it may indicate a sinus infection.


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