[39F] With nasal crusting, bleeding, and fatigue
Patient Description
A 39-year-old female presents with crusting and bleeding in the right nostril, particularly when blowing her nose. She reports feeling warm but has not measured her temperature. The patient experiences pressure and pain in the nose when touched, along with swelling and redness. Fatigue is also a significant concern, although she feels it is secondary to the nasal issues. She has a history of Crohn's disease, endometriosis, autism, and ARFID, diagnosed in 1999, 2007, 1990, and 2004 respectively. No current medications, but previously took Adderall 30 mg twice daily. No recent infections or skin conditions elsewhere on the body. No use of nasal sprays or recent contact with individuals with similar symptoms. Recent travel included staying in hotels within Colorado. Allergic to SSRIs.
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Arora's Assessment
What might be happening
Based on your symptoms, here are some possibilities:
-
Nasal Vestibulitis: This is an infection of the nasal vestibule, often caused by bacteria like Staphylococcus. It can lead to crusting, bleeding, and discomfort in the nose.
- Treatment typically involves topical antibiotics and sometimes oral antibiotics if the infection is more severe.
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Sinus Infection (Sinusitis): This can cause nasal congestion, pressure, and sometimes fever. It might also lead to crusting if the nasal passages are irritated.
- Treatment may include decongestants, nasal saline rinses, and sometimes antibiotics if a bacterial infection is suspected.
-
Seborrheic Dermatitis: Given your mention of sebum buildup on the scalp, this condition can also affect the nose, causing redness and crusting.
- Treatment often involves medicated shampoos and topical treatments.
What you can do
- Warm Compresses: Apply a warm, damp cloth to your nose to help soften crusts and relieve discomfort.
- Saline Rinses: Use a saline nasal spray or rinse to keep your nasal passages moist and clear.
- Avoid Picking: Try not to touch or pick at the crusts to prevent further irritation or infection.
- Monitor Symptoms: Keep track of your symptoms using MDandMe to journal your progress and share insights with your healthcare provider.
What you should look out for
Seek medical attention if you experience:
- Increased redness, swelling, or pain in your nose or face
- High fever or chills
- Persistent or worsening symptoms despite home care
Remember, it's important to consult a healthcare professional for a formal diagnosis and treatment plan.
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4 mo ago