[42F] With facial pain, nasal congestion, and swollen lymph node

Patient Description

A 42-year-old female has been experiencing pain and swelling in her right nostril and right cheek, along with a painful, swollen lymph node under her jaw for the past two days. The pain is dull and rated as a 3 out of 10 normally, increasing to a 5 when touched. She also reports a constant pressure under her right eye, rated as a 4 out of 10, which worsens with movement or bending over and is somewhat relieved by ibuprofen. Additionally, she has nasal congestion with greenish-yellow discharge but no fever, cough, sore throat (though her upper lip is sore), or changes in her sense of smell. There has been no recent exposure to anyone with a respiratory infection. She does not smoke or use tobacco products and has no known allergies or chronic medical conditions, except for a reaction to codeine which makes her itchy. Her current medications include Zoloft, Lipitor, Benazapril, Metformin, and Wellbutrin, all taken once a day, though the exact dosages are unknown. She is not taking any over-the-counter medications, supplements, or herbal remedies, and there have been no recent changes in her medications or dosages.

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Arora's Assessment

What might be happening

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

  • Sinusitis (Sinus Infection): This is an inflammation or swelling of the tissue lining the sinuses. It can cause pain and pressure in the face, nasal congestion, and greenish-yellow nasal discharge. The pain and pressure can worsen with movement or bending over.

    • Treatment: Sinusitis can often be treated with over-the-counter decongestants, saline nasal sprays, and pain relievers like ibuprofen. In some cases, a doctor may prescribe antibiotics if a bacterial infection is suspected.
  • Lymphadenitis: This is an infection of the lymph nodes, which can cause them to become swollen and tender. It often occurs alongside other infections, such as sinusitis.

    • Treatment: Treatment typically involves addressing the underlying infection, which may include antibiotics if a bacterial infection is present. Warm compresses and pain relievers can help alleviate discomfort.
  • Nasal Polyps: These are noncancerous growths on the lining of your nasal passages or sinuses that can cause congestion, pressure, and pain.

    • Treatment: Treatment may include nasal corticosteroid sprays to reduce inflammation or, in some cases, surgery to remove the polyps.

What you can do

While it's important to consult a healthcare professional for a formal diagnosis and treatment plan, here are some steps you can take to help alleviate your symptoms:

  1. Stay Hydrated: Drink plenty of fluids to help thin mucus and promote drainage.
  2. Use a Humidifier: Adding moisture to the air can help relieve nasal congestion and sinus pressure.
  3. Apply Warm Compresses: Placing a warm, damp cloth on your face can help reduce pain and pressure.
  4. Over-the-Counter Medications: Use decongestants, saline nasal sprays, and pain relievers like ibuprofen to manage your symptoms.
  5. Rest: Ensure you get plenty of rest to help your body fight off the infection.
  6. Track Your Symptoms: Use MDandMe to journal your symptoms, track your progress, and share your notes with your healthcare provider.

What you should look out for

Seek medical attention if you experience any of the following:

  • High Fever: A temperature over 100.4°F that doesn't go away.
  • Severe Pain: Pain that becomes unbearable or significantly worsens.
  • Vision Changes: Blurred or double vision.
  • Swelling Around the Eyes: Significant swelling or redness around the eyes.
  • Persistent Symptoms: Symptoms that do not improve or worsen after a week of home treatment.

Remember, while these suggestions can help manage your symptoms, it's important to consult a healthcare professional for a formal diagnosis and appropriate treatment.

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6 mo ago

People Also Ask


What are the common symptoms of sinusitis?

Common symptoms of sinusitis include facial pain or pressure, nasal congestion, greenish-yellow nasal discharge, reduced sense of smell, and sometimes fever. The pain often worsens with movement or bending over.


How can I differentiate between a viral and bacterial sinus infection?

Viral sinus infections typically improve within 7-10 days and may not require antibiotics, while bacterial infections often persist longer and may cause more severe symptoms, such as high fever and facial pain. A healthcare provider can help determine the cause and appropriate treatment.


What are the treatment options for swollen lymph nodes due to an infection?

Swollen lymph nodes due to an infection, known as lymphadenitis, are often treated by addressing the underlying infection. This may include antibiotics if a bacterial infection is suspected. Warm compresses and over-the-counter pain relievers can help alleviate discomfort.


When should I seek medical attention for sinus-related symptoms?

You should seek medical attention if you experience a high fever over 100.4°F, severe or worsening pain, vision changes, significant swelling or redness around the eyes, or if your symptoms do not improve or worsen after a week of home treatment.


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