[45F] With eye pain, sore throat, and nasal congestion

Patient Description

A 45-year-old female presents with continuous eye pain for the past week, without any recent injuries to the eye or head, and no redness or discharge. She also reports a sore throat for the past three days, which causes pain when swallowing and came on gradually. Hot tea provides some relief. Additionally, she has swollen lymph nodes but no known fever. Other symptoms include nasal congestion, slight cough, body aches, fatigue, headaches, and facial pain/pressure. These symptoms began after attending a wedding with 175 people, held both indoors and outdoors. Medications include Benadryl (25-50 mg once a day), Allegra (180 mg once a day), NyQuil (2 tablespoons a day), and Joyeaux Birth Control (once daily). She has an allergy to Aleve but no other known medication allergies.

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Arora's Assessment

What might be happening

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

  • Viral Upper Respiratory Infection (Common Cold): This is a frequent cause of symptoms like sore throat, nasal congestion, body aches, fatigue, and mild cough. Eye pain can sometimes occur due to sinus pressure or congestion.

    • Treatment: Typically, rest, hydration, and over-the-counter medications like decongestants and pain relievers are recommended. Symptoms usually resolve within a week or two.
  • Sinusitis: Inflammation or infection of the sinuses can cause nasal congestion, facial pain/pressure, headache, and sometimes eye pain. It can be viral or bacterial.

    • Treatment: For viral sinusitis, rest, hydration, and over-the-counter medications can help. If bacterial, a doctor may prescribe antibiotics.
  • Allergic Rhinitis: Allergies can cause nasal congestion, sore throat, and fatigue. Eye pain can occur due to sinus pressure or allergic conjunctivitis.

    • Treatment: Antihistamines (like Benadryl and Allegra), nasal corticosteroids, and avoiding allergens can help manage symptoms.
  • Pharyngitis: Inflammation of the throat, often due to viral or bacterial infections, can cause sore throat and pain when swallowing.

    • Treatment: Viral pharyngitis is managed with rest, hydration, and over-the-counter pain relievers. Bacterial pharyngitis (like strep throat) may require antibiotics.

What you can do

  1. Rest and Hydrate: Ensure you get plenty of rest and drink fluids to stay hydrated.
  2. Over-the-Counter Medications: Continue using Benadryl, Allegra, and NyQuil as they seem to help. You can also use pain relievers like acetaminophen or ibuprofen (if not allergic) for body aches and headaches.
  3. Warm Fluids: Drinking warm fluids like hot tea can soothe your sore throat.
  4. Humidifier: Using a humidifier can help alleviate nasal congestion and throat irritation.
  5. Monitor Symptoms: Keep track of your symptoms using the MDandMe journal. This can help you identify any patterns or triggers and provide useful information to 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 down with over-the-counter medications.
  • Severe Pain: Intense headache, facial pain, or eye pain that doesn't improve with rest and medication.
  • Worsening Symptoms: If your symptoms worsen or don't improve after a week.
  • Difficulty Breathing: Any signs of difficulty breathing or shortness of breath.
  • Swelling or Redness: Increased swelling or redness around the eyes or face.

Remember, while I can provide information and suggestions, it's important to consult with a healthcare professional for a formal diagnosis and treatment plan. If you have any further questions or need more personalized advice, please reach out to your doctor.

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4 mo ago


People Also Ask


What are the common symptoms of a viral upper respiratory infection?

Common symptoms of a viral upper respiratory infection, such as the common cold, include sore throat, nasal congestion, body aches, fatigue, mild cough, and sometimes headaches or facial pain due to sinus pressure.


How can sinusitis cause eye pain?

Sinusitis can cause eye pain due to the pressure and inflammation in the sinus cavities, which are located near the eyes. This pressure can lead to discomfort or pain in the eye area.


What are effective treatments for allergic rhinitis?

Effective treatments for allergic rhinitis include antihistamines like Benadryl and Allegra, nasal corticosteroids, and avoiding known allergens. These can help manage symptoms such as nasal congestion, sore throat, and fatigue.


When should I seek medical attention for a sore throat?

You should seek medical attention for a sore throat if you experience a high fever over 100.4°F, severe pain, worsening symptoms after a week, difficulty breathing, or increased swelling or redness around the eyes or face.

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