[53M] With sore throat, headache, and earache

Patient Description

A 53-year-old male has been experiencing a sore throat for the past two days, which came on suddenly. The sore throat is accompanied by swelling, redness, and small white pimples in the throat. Swallowing is very painful, especially on one side, and it is particularly difficult to swallow solids. The patient also reports ear pain for the past day, which worsens when swallowing, and a headache at the back of the head, described as an ache with an intensity of 3 out of 10. The patient has slightly swollen lymph nodes around the neck and slight nasal congestion but no coughing or shortness of breath. The patient has not measured their temperature and is unsure about having a fever. There has been no recent contact with sick individuals or travel to areas with known outbreaks of infectious diseases. The patient is currently taking Lisinopril (5 mg once daily) and Valacyclovir (500 mg once daily), along with ibuprofen and Airborne for symptom relief. There are no known medication allergies and no significant past medical history or chronic illnesses, except for a family history of diabetes.

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Arora's Assessment

What might be happening

Based on the information you have provided, here are some possible explanations for your symptoms:

  • Strep Throat: This is a bacterial infection caused by Streptococcus pyogenes. It often presents with a sudden sore throat, pain when swallowing, red and swollen tonsils, and white patches or streaks of pus. Headache and swollen lymph nodes are also common.

    • Treatment: A doctor can confirm strep throat with a rapid strep test or throat culture. If positive, antibiotics are typically prescribed to treat the infection.
  • Tonsillitis: This is an inflammation of the tonsils, which can be caused by both viral and bacterial infections. Symptoms include sore throat, difficulty swallowing, red and swollen tonsils, and white or yellow patches on the tonsils. Ear pain and headache can also occur.

    • Treatment: If bacterial, antibiotics may be prescribed. Viral tonsillitis usually resolves on its own, but supportive care like rest, hydration, and over-the-counter pain relievers can help.
  • Viral Pharyngitis: This is a viral infection that causes inflammation of the throat. Symptoms can include sore throat, headache, slight nasal congestion, and swollen lymph nodes. It is often less severe than bacterial infections.

    • Treatment: Viral infections typically resolve on their own. Supportive care includes rest, hydration, and over-the-counter pain relievers like ibuprofen.

What you can do

While you should consult a healthcare provider for a formal diagnosis and treatment, here are some steps you can take to alleviate your symptoms:

  1. Stay Hydrated: Drink plenty of fluids to keep your throat moist and to help your body fight the infection.
  2. Rest: Ensure you get plenty of rest to help your body recover.
  3. Over-the-Counter Pain Relievers: Continue taking ibuprofen as needed to manage pain and reduce inflammation.
  4. Warm Salt Water Gargle: Gargling with warm salt water can help soothe your sore throat.
  5. Throat Lozenges or Sprays: These can provide temporary relief for throat pain.
  6. Humidifier: Using a humidifier can help keep your throat moist and reduce discomfort.
  7. Avoid Irritants: Stay away from smoke and other irritants that can worsen your symptoms.

You can also use MDandMe to journal your symptoms, track your progress, get insights, and share longitudinal medical 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 persists.
  • Difficulty Breathing: Any signs of respiratory distress.
  • Severe Pain: If the pain becomes unbearable or significantly worsens.
  • Inability to Swallow: If you find it extremely difficult to swallow even liquids.
  • Persistent Symptoms: If your symptoms do not improve or worsen over the next few days.

Remember, while this advice can help you manage your symptoms, it is important to consult a healthcare professional for a formal diagnosis and appropriate treatment.

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3 mo ago


People Also Ask


What are the common symptoms of strep throat?

Common symptoms of strep throat include a sudden sore throat, pain when swallowing, red and swollen tonsils, white patches or streaks of pus on the tonsils, headache, and swollen lymph nodes. Fever may also be present.


How can I differentiate between viral and bacterial tonsillitis?

Bacterial tonsillitis often presents with more severe symptoms such as high fever, swollen tonsils with white or yellow patches, and swollen lymph nodes. Viral tonsillitis may have milder symptoms and is often accompanied by cold-like symptoms such as a runny nose or cough.


What home remedies can help alleviate a sore throat?

Home remedies for a sore throat include staying hydrated, gargling with warm salt water, using throat lozenges or sprays, using a humidifier, and avoiding irritants like smoke. Over-the-counter pain relievers like ibuprofen can also help manage pain.


When should I seek medical attention for a sore throat?

You should seek medical attention if you experience a high fever over 100.4°F that persists, difficulty breathing, severe pain, inability to swallow even liquids, or if your symptoms do not improve or worsen over the next few days.


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