[35F] With severe ear pain, mild headache, and dry cough

Patient Description

A 35-year-old female presents with severe ear pain described as a constant pain with a sensation of buzzing or water in the ear. The pain worsens with swallowing, drinking, or burping. The patient also reports some difficulty hearing due to pain and swelling behind the ear. Additionally, the patient has a mild, throbbing headache that started today and has not been relieved by any measures. The patient has had a constant dry cough for a week, which is rated as mild. She is experiencing vomiting and is unable to hold anything down, preventing her from taking medications for her headache. The patient has a low-grade fever, nasal congestion, and a runny nose. She reports a little facial pain or pressure and a sore throat that worsens with swallowing or coughing. The patient has a history of ear and sinus infections occurring once or twice a year, usually with weather changes, but nothing as severe as the current episode. She has not had any recent injuries to her ear or head and has not traveled recently or been exposed to anyone who is sick. The patient is currently taking Ibuprofen and Tylenol but is unable to keep them down due to vomiting.

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Arora's Assessment

What might be happening

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

Ear Pain, Hearing Difficulty, and Swelling

  • Ear Infection (Otitis Media or Otitis Externa): Given your history of ear infections and the severe pain, swelling, and hearing difficulty, it's possible you have an ear infection. Ear infections can cause pain, a feeling of fullness, and sometimes hearing loss. They can also lead to fever and general discomfort.
  • Eustachian Tube Dysfunction: This can cause a feeling of fullness or pressure in the ear, pain, and sometimes hearing loss. It often occurs with nasal congestion and can be related to sinus infections or allergies.

Headache and Facial Pain

  • Sinus Infection (Sinusitis): Your symptoms of nasal congestion, runny nose, facial pain, and headache suggest a possible sinus infection. Sinus infections can cause throbbing headaches, especially when bending over or lying down, and can be accompanied by ear pain due to pressure changes.

Cough and Sore Throat

  • Upper Respiratory Infection (Common Cold or Viral Infection): A dry cough, sore throat, and nasal congestion are common symptoms of an upper respiratory infection. These infections can also cause low-grade fever and general malaise.

Vomiting

  • Gastroenteritis or Reaction to Infection: Vomiting can sometimes occur as a reaction to an infection or due to gastroenteritis. It can also be a side effect of severe pain or fever.

What you can do

Ear Pain and Hearing Difficulty

  • See a Doctor: Given the severity of your ear pain and the associated symptoms, it's important to see a healthcare provider as soon as possible. They may prescribe antibiotics if a bacterial infection is suspected or recommend other treatments.
  • Warm Compress: Applying a warm compress to the affected ear can help alleviate pain.
  • Stay Hydrated: Drink plenty of fluids to stay hydrated, especially if you are vomiting.

Headache and Facial Pain

  • Over-the-Counter Pain Relief: If you can manage to keep it down, over-the-counter pain relievers like acetaminophen (Tylenol) or ibuprofen can help alleviate headache and facial pain. However, since you're having trouble keeping medications down, this may not be feasible.
  • Steam Inhalation: Inhaling steam from a bowl of hot water or taking a hot shower can help relieve nasal congestion and sinus pressure.

Cough and Sore Throat

  • Stay Hydrated: Drink plenty of fluids to help soothe your throat and keep your body hydrated.
  • Humidifier: Using a humidifier in your room can help keep the air moist and reduce throat irritation.
  • Saltwater Gargle: Gargling with warm salt water can help soothe a sore throat.

Vomiting

  • Small Sips of Clear Fluids: Try to take small sips of clear fluids like water, broth, or an electrolyte solution to stay hydrated.
  • Avoid Solid Foods: Until the vomiting subsides, avoid solid foods and stick to clear liquids.

General Tips

  • Rest: Make sure to get plenty of rest to help your body recover.
  • Monitor Symptoms: Keep track of your symptoms using the MDandMe journal. This can help you and your healthcare provider understand the progression of your illness and make informed decisions about your care.

What you should look out for

Given the severity of your symptoms, you should seek medical care as soon as possible. Reasons to seek care even more urgently include:

  • High Fever: If your fever increases or becomes high.
  • Severe Headache: If your headache becomes severe or is accompanied by neck stiffness.
  • Persistent Vomiting: If you continue to vomit and cannot keep any fluids down.
  • Worsening Ear Pain: If the pain in your ear worsens or you develop new symptoms like discharge from the ear.
  • Shortness of Breath: If you experience difficulty breathing or shortness of breath.

Remember, while I can provide information and suggestions, it's important to consult with a healthcare professional for a formal diagnosis and appropriate treatment. If you have any more questions or need further assistance, feel free to continue the conversation.

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6 mo ago

People Also Ask


What are the common symptoms of an ear infection?

Common symptoms of an ear infection include severe ear pain, a sensation of fullness or pressure in the ear, hearing difficulty, fever, and sometimes fluid drainage from the ear.


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

A sinus infection often includes symptoms like facial pain or pressure, nasal congestion, thick nasal discharge, and a headache that worsens when bending over. A common cold typically involves a runny nose, sore throat, and cough, but without the intense facial pain or pressure.


What are some home remedies to alleviate ear pain?

Home remedies for ear pain include applying a warm compress to the affected ear, staying hydrated, and using over-the-counter pain relievers if you can keep them down. It's also important to see a doctor if the pain is severe.


When should I seek medical attention for vomiting?

You should seek medical attention for vomiting if it is persistent and you cannot keep any fluids down, if it is accompanied by severe pain, high fever, or if you show signs of dehydration such as dizziness, dry mouth, or reduced urination.


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