[79M] With headache, facial pressure, and dental pain post-COVID

Patient Description

A 79-year-old male presents with a headache and pressure in the neck, ears, cheeks, and forehead for about 2 hours. The headache is rated as 5/10 in intensity and worsens with bending over, looking down, or exposure to hot temperatures. Laying on his back and tilting his head back slightly helps relieve the pain. The headache came on suddenly and is accompanied by clear nasal discharge but no fever. Additionally, the patient has swollen gums and tooth pain on the bottom right side of the mouth, closer to the back, starting today. The pain is very tender, hot, and makes the teeth feel loose, rated as 7/10 in severity. The patient experienced an extremely sore throat and swollen lymph nodes in the neck two days ago, which made it difficult to eat or drink. Once the sore throat subsided, the pressure in the face, head, and neck started, followed by the headache. The patient occasionally experiences shortness of breath but no chest pain or tightness. Vision has been hard to focus for a few minutes at a time, with episodes of dizziness and lightheadedness, and numbness or tingling in the fingers. The patient smokes about 15 cigarettes per day for the past 7 years. Medical history includes thalassemia anemia diagnosed at birth and kidney problems diagnosed in June 2024. The patient is allergic to penicillin, sulfa, and vancomycin and is not currently taking any medications.

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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): The pressure in your face, forehead, and neck, along with clear nasal discharge, suggests that you might have sinusitis. Sinusitis can cause headaches, facial pain, and pressure, especially when bending over. It can also lead to tooth pain and swollen gums due to the proximity of the sinuses to the upper teeth.

    • Treatment: Sinusitis is often treated with decongestants, nasal saline rinses, and sometimes antibiotics if a bacterial infection is suspected. Over-the-counter pain relievers can help manage the pain.
  • Dental Infection or Abscess: The swollen gums, tooth pain, and tenderness could indicate a dental infection or abscess. This can sometimes cause referred pain and pressure in the face and head.

    • Treatment: Dental infections typically require antibiotics and possibly drainage of the abscess. A dentist may need to perform a procedure to address the underlying issue.
  • Post-Viral Syndrome: Given your recent COVID-19 infection, it's possible that your symptoms are related to post-viral syndrome. This can include lingering symptoms like headaches, sinus pressure, and fatigue.

    • Treatment: Post-viral symptoms often improve with rest, hydration, and over-the-counter pain relievers. Monitoring your symptoms and consulting with a healthcare provider is important.

What you can do

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

  1. Stay Hydrated: Drink plenty of fluids to help thin mucus and relieve sinus pressure.
  2. Use a Humidifier: Adding moisture to the air can help ease sinus congestion and discomfort.
  3. Warm Compresses: Applying a warm compress to your face can help relieve sinus pressure and pain.
  4. Over-the-Counter Medications: Consider using decongestants, nasal saline rinses, and pain relievers like ibuprofen or acetaminophen to manage your symptoms.
  5. Dental Care: If you suspect a dental issue, rinse your mouth with warm salt water and avoid chewing on the affected side. Schedule an appointment with your dentist as soon as possible.
  6. Rest: Ensure you get plenty of rest to help your body recover from the recent viral infection.
  7. Symptom Tracking: 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 more urgently if you experience any of the following:

  • Severe or Worsening Symptoms: If your headache, facial pressure, or tooth pain becomes more severe or doesn't improve with over-the-counter treatments.
  • High Fever: If you develop a fever over 100.4°F, which could indicate a bacterial infection.
  • Difficulty Breathing: If you experience significant shortness of breath or chest pain.
  • Swelling or Redness: If you notice increased swelling, redness, or warmth in your gums or face, which could indicate an abscess or spreading infection.
  • Vision Changes: If you experience persistent vision changes or double vision.

Remember, while I can provide guidance based on your symptoms, it's important to consult with 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 sinusitis?

Common symptoms of sinusitis include facial pain or pressure, nasal congestion, nasal discharge (which can be clear or colored), reduced sense of smell, and headaches. These symptoms often worsen when bending over or lying down.


How can a dental infection cause facial pain and pressure?

A dental infection, such as an abscess, can cause facial pain and pressure because the roots of the upper teeth are close to the sinuses. Infections can lead to referred pain, where the pain is felt in areas other than the site of the infection.


What is post-viral syndrome and how does it relate to COVID-19?

Post-viral syndrome refers to lingering symptoms that persist after the acute phase of a viral infection, such as COVID-19. These symptoms can include fatigue, headaches, sinus pressure, and general malaise, and they may last for weeks or months.


What are some effective home remedies for sinus pressure relief?

Effective home remedies for sinus pressure relief include staying hydrated, using a humidifier, applying warm compresses to the face, and using over-the-counter decongestants or nasal saline rinses. These methods can help reduce congestion and alleviate discomfort.


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