This jaw pain is classified as "temporomandibular disorder" (TMD) Doctors believe the condition is likely caused by open-mouth . Cephalalgia. Gentle intentional movements connect to the mind and body and can help make moving easier and more comfortable, reducing chronic symptoms and increasing energy. The question asked on this page is a free question. Objectives: Another long Covid symptom that is starting to present in more patients is muscle pain, which, like all long Covid symptoms, can be caused by several . Important radiological findings and variations found in post COVID19 AIFR cases. When blood clots prevent nutrients from getting to the retina, the . If they are severe enough or frequent enough, we may start preventative medications such as beta-blockers, anti-epileptics, or tricyclic anti-depressants, which are meds that we commonly use to prevent chronic daily headaches," McConnell said. From a runny nose to diarrhea, the Omicron variant can lead to several health complications. Also explore types, prevention, and more. Unable to load your collection due to an error, Unable to load your delegates due to an error, Different patterns of palatal involvement with invasive fungal infection; (A) small palatal ulcers. These symptoms typically occur along with other common sinus infection symptoms, such as a runny or stuffy nose. Therefore steroid nasal drops/sprays and antihistamines are frequently the first order of treatment. Source: Centers for Disease Control and Prevention. *Email us for video download password Content is property of Cleveland Clinic and for news media use only. Omicron enters the respiratory. However MRI findings in ANE are T2 AND FLAIR hyperintensities in basal ganglia,internal capsule, thalamus, cerebellum and rarely in occipital and parietal lobes. Health is a serious topic and therefore we present you with engaging, straightforward and expert-reviewed content that helps you make the best decision for any health-related queries. Survivors of the 1890 flu pandemic had experienced post-infection symptoms months to years after the pandemic ended. Myalgia, according to John Hopkins Medicine, describes a range of muscle pains, with symptoms that include muscle cramps and joint pain. Long COVID can affect nearly all parts of the body with multiple and varied symptoms. Youve gone at least 24 hours without a fever without using fever-reducing medications like, aches and pains in your muscles or joints. The best way to treat sinusitis is with steroid nasal spray as the decongestant may give good immediate relief but commonly causes rebound congestion within a few hours. "It's a well-known fact that myalgias are commonly seen in viral infections. Heart damage or cardiac muscle injury complication is seen after several days or weeks of recovery. Email us atexclusive@the-sun.comor call212 416 4552. eCollection 2023. Mayo, Mayo Clinic, MayoClinic.org, Mayo Clinic Healthy Living, and the triple-shield Mayo Clinic logo are trademarks of Mayo Foundation for Medical Education and Research. In the U.S. alone, about 80 million people have been infected with the coronavirus since the pandemic started in early 2020. Foods rich in Vitamin C are citrus fruits, spinach, papaya, kiwi, tomato, mango and strawberries are a few good sources. One of the documented complications was a persistent, daily headache. You can typically be around others again if all of the following are true: Long-haul COVID-19 can last for weeks or months. OurCooper experts have put together a guide to help you differentiate the two. All content 2022Cooper University Health Care. (D) T2weighted axial MRI shows right orbital invasion with right temporal lobe abscess (yellow arrow) with occlusion of the right internal carotid artery. COVID-19 isn't just an infection that affects the respiratory system, but has a huge impact on the mental state of a person. 2021 The American Laryngological, Rhinological and Otological Society, Inc.. Researchers have noticed that some patients who have fully recovered from the Omicron Covid-19 variant are continuing to experience persistent back ache and pain. Get in touch with a doctor or your states health department to find testing sites near you. 216-444-0141 This is most likely multifactorial as many patients with [long COVID] are already suffering from fatigue and non-restorative sleep, both of which can trigger migraine headaches," she said. In particular, women and young adults (those with a mean age of 33) are more . Complications like acute pulmonary thromboembolism, deep vein thrombosis, acute limb ischemia/ gangrene, mesenteric ischaemia are seen. License and Republishing. Taken home t, I have this cold and cough everyday but after covid near throat I get whistle sounds like infection once, My father had mucormycosis last year for which he was treated with maxillectomy 15 months back (post his, Hi it's been more than a month I have been having this much in throat it's very irritating it isn't comin, I got affected with covid 8 days back and have recovered completely. Dokania V, Gaikwad NS, Gite V, Mhashal S, Shetty N, Shinde P, Balakrishnan A. Ann Otol Rhinol Laryngol. Contact a doctor if your symptoms dont improve or get worse after 10 days. Nature 2020;579:270273. Dr. Munjal added that mucormycosis a rare fungal infection has cost many COVID-19 patients their vision, jawbones, nose. Hypertensive and diabetic COVID-19 patients are at a higher risk of kidney complication post COVID-19. The COVID-19 infection period varies from person to person. People with long COVID report experiencing different combinations of symptoms like tiredness or fatigue, difficulty thinking or concentrating (sometimes referred to as "brain fog"), headache, loss of smell or taste, dizziness on standing, fast-beating or pounding heart (also known as heart palpitations), chest pain, difficulty breathing or shortness of breath, cough, joint or muscle pain, depression or anxiety, fever. (C) Central palatal ulceration with necrosis. Discover your full benefits as a Premium subscriber. But There Are Solutions For Unexplained Infertility, Can Stress Make Your Hair Fall Out? 2022. After a few swabs, some questions and a chest x-ray, my husband and I were sent home since our symptoms were minor. It is unknown how long multiorgan system effects might last and whether the effects could lead to chronic health conditions. Post-COVID syndrome is real and it is important that patients should pay heed to recover the body. While there are breakthrough cases of Covid among people who are vaccinated, they are rare. Changes on how the central nervous system processes pain, fatigue, or other signals can lead to a variety of symptoms. Is this just a residual symptom or could I have a sinus infection? Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 4 Laryngoscope, 131:2652-2658, 2021. Acute invasive fungal rhinosinusitis: our experience with 18 cases. We'll personally contact you soon for confirmation. It can affect your upper respiratory tract (sinuses, nose, and throat) or lower respiratory tract (windpipe and lungs). "The clinical group also . Epub 2016 Jun 7. There is no quick fix, but the strategies I've explained here can help you work towards feeling better. Ann Clin Lab Sci. Extreme Fatigue. Post-COVID recovery Online ahead of print. Longitudinal prospective study. Here are four of the most common eye problems that may develop after COVID infection, according to the new analysis. Daily persistent headache after a viral illness during a worldwide pandemic may not be a new occurrence: Lessons from the 1890 Russian/Asiatic flu. In an interview with Livemint, Dr Harish Chafle, a senior consultant at Global Hospital, explained the back-breaking pain caused while recovering from Omicron. Apart from mild fever, scratchy throat and clogged nose, several patients who have been infected. Epub 2021 Dec 1. Copyright 2017, Practo. eCollection 2022 Dec. Indian J Otolaryngol Head Neck Surg. But yes, it is very common to have a post-Covid sinusitis (as you describe above) or bronchitis (inflammation in lung airways) which results in a persistent cough. Covid-19 with cytokine storm leads to immune mediated damage with predilection to Central nervous system. (A) Axial CT showing right subperiosteal abcess. Read more, Pilonidal Sinus is a disease commonly seen in the people with hairy skin. Anxiety, depression, sleep disturbances, lack of concentration, anhedonia and suicidal tendencies have also been reported. Experts have warned about the possible long-COVID symptoms earlier when the country was fighting the delta variant of coronavirus. Follow-up for survived patients was maintained regularly for the first postoperative month. Plan to stay home until you receive your test result. 2023 Jan 27;16:201-211. doi: 10.2147/JAA.S398686. Read more, Are you the one who always get cold and allergy attack accompanied with a runny nose, sneezing, red, stuffy nose, facial Unique symptoms of COVID-19 that are rarely present during a sinus infection include: A reduced sense of smell can happen over 60 percent of the time during a sinus infection or a cold. Headaches can be similar to a constant tension headache or a throbbing pain like a migraine attack. If you have flu-like symptoms and think you may have been exposed to COVID-19, please review our instructions and information on our testing sites. Speaking to the media, Dr. Ann Mary, Consultant, General Medicine, Amrita Hospital, Kochi, said, "Back pain, though common in most viral fevers, but compared to Delta, Omicron patients tend to have more back pain and less loss of smell and taste." Can Asymptomatic COVID Infections Result in Long COVID? Am J Respir Crit Care Med 2021;203:307317. I had it during covid aswell but I assumed it's my sinuses and it went away with the covid symptoms. Bakhshaee M, Bojdi A, Allahyari A, Majidi MR, Tavakol S, Najafzadeh MJ, Asghari M. Eur Arch Otorhinolaryngol. Even if you know you have a sinus infection or COVID-19, speak with a doctor if your symptoms dont improve or begin to get worse. Signs and Symptoms of the New Coronavirus and COVID-19, Nicole Leigh Aaronson, MD, MBA, CPE, FACS, FAAP, Endoscopic Sinus Surgery: The Procedure and Recovery Process, Glycemic Index: What It Is and How to Use It, sinus pain or pressure felt around the upper cheeks, forehead, or inner portion of the eyes, drinking plenty of fluids to help loosen mucus, taking over-the-counter (OTC) medications to relieve fever, discomfort, and nasal congestion. instructions and information on our testing sites. 2021;1(1):S31-S36. The cardinal symptoms are nasal mucopurulent drainage, nasal congestion, facial pain/pressure and decreased sense of smell. Sino-nasal, orbital, cerebral, and palatine involvement was found in 100%, 80.6%, 27.8%, and 33.3% of patients, respectively. There are several other long-term Omicron symptoms that can last for months and here is how you can relieve them. Lingering Omicron symptom can cause pain long after you've recovered from Covid. Unauthorized use of these marks is strictly prohibited. Post-COVID recovery Find out about possible causes of post-COVID-19 conditions and ways to manage symptoms. The immune system could have been "confused by the virus to think that normal components of the brain need to be attacked," Koralnik said. Aside from rashes, these patients could experience symptoms that can appear in COVID-19 as well as other conditions, including fevers, chest pain, heart problems, and gastrointestinal issues. Multiorgan effects can also include conditions that occur after COVID-19, like multisystem inflammatory syndrome (MIS) and autoimmune conditions. Should I get a vaccine if Ive had COVID-19? The results make clear thateven in those with a mild-to-moderate infectionthe effects of COVID-19 can persist in the lungs for months. Overall survival rate was 63.89% (23/36). 4. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. But There Are Solutions For Unexplained Infertility, Can Stress Make Your Hair Fall Out? All patients were treated simultaneously by surgical debridement with antifungal medications except for two patients with PCR-positive swab for COVID-19. While a sinus infection could develop following COVID-19, this hasnt yet been reported by research. A doctor may recommend endoscopic sinus surgery if you're experiencing recurrent sinus infections or have a sinus blockage. COVID associated mucormycosis: A preliminary study from a dedicated COVID Hospital in Delhi. Mucormycosis and aspergillosis: The deadly duo in COVID-19-a case report. Headaches are one of the most common symptoms of COVID-19. I was on, I had covid test postive exactly 30 days back and after 7 days being positive i had mild pneumonia . Premium subscribers enjoy unlimited access to all articles. COVID-19 symptoms can develop more gradually 2 to 14 days after exposure to SARS-CoV-2. 2022 Jan-Feb;43(1):103220. doi: 10.1016/j.amjoto.2021.103220. Characteristics of headache attributed to COVID-19 infection and predictors of its frequency and intensity: A cross sectional study. Being physically active or having a structured exercise program can help as well. About Author: Luke Legner Luke Legner is a writing coordinator at OSF HealthCare. The Omicron variant of COVID-19 has been found to be the most transmissible strain of the SARS-CoV-2 virus causing coronavirus. Their ear pain also may linger after recovering from the disease. In COVID-19, loss of smell and taste is almost complete and can also happen even without a runny or stuffy nose. Welcome! Frequently asked questions about COVID-19 vaccination. Joint and Chest Pain. Muscle or body aches. Mind and body practices such as yoga and tai-chi can also help relax your body and your mind. There is limited evidence regarding lasting COVID-19 symptoms after the infection is gone. Use a Warm Compress. A 2020 study surveyed 270 outpatients with COVID-19. As both are immune mediated and are due to post covid complications they tend to be similar. All rights reserved. Older adults and those with certain health conditions are at a higher risk of serious illness. When fluid builds up in your sinuses, germs like viruses and bacteria can multiply and lead to a sinus infection. Coronavirus binds to ACE receptors which are abundant in glial cells and arterial smooth cells in the brain, that is why neurological manifestations are seen in Covid-19 and also post covid complications. Some people may experience long-haul COVID-19, a group of symptoms that persist in the weeks and months following an infection. Post COVID-19 care: Whether it is a pestering headache or an episode of fatigue, it is essential to focus on any noticeable signs that your body isn't approving the post-COVID situation. It describes an inflammatory condition affecting the nasal passage and paranasal sinuses which can occur at any age but most commonly in our 30s and 40s. Tell-Tale Signs Youre Under Too Much Pressure, Effects Of Cosmetic Products: Myths And Facts, , , Ayushman Card Apply: ? There's no conclusive data yet, but it's possible that post-COVID headache is caused by systemic inflammation during the acute phase of COVID-19 or related to constant immune activation. Some may only notice mild symptoms, while some may experience the severe symptoms of the infection, some can also end up being asymptomatic during the course of the recovery phase, but post-recovery symptoms can be worrisome. Researchers suggested that the many similarities between the 1890 pandemic and the current pandemic mean that headache of a similar nature is a possible consequence of COVID-19. 2023;31:e01664. Disclaimer : The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. so d, I recovered from covid under self isolation and medication 1 MONTH BACK. I feel as if my intestines are sore on the inside. It can be overwhelming and frustrating. Long COVID is a range of symptoms that can last weeks or months after first being infected with the virus that causes COVID-19 or can appear weeks after infection. COVID-19 seems to have the potential to cause pain in a variety of ways, including damage to peripheral nerves causing neuropathy-like symptoms, by affecting pain pathways inside the brain,. Regularly updated for everything you need to know about the novel coronavirus (COVID-19). Tell-Tale Signs Youre Under Too Much Pressure, Effects Of Cosmetic Products: Myths And Facts, , , Ayushman Card Apply: ? Currently, many experts think symptoms of post COVID syndrome could be due to how the COVID infection affected the central nervous system, which includes the brain and spinal cord. "Vaccination is a great tool. Experts recommend getting vaccinated and boosted against COVID-19 to avoid severe outcomes from the disease. The most common long-term complication of COVID-19 is lung disease. official website and that any information you provide is encrypted However, exact pathophysiology is not known. But are they different from other types of headaches? You should also try using a sinus rinse that can be bought in any pharmacy as this can wash out the allergens and help clear mucus. window._taboola = window._taboola || []; _taboola.push({ mode: "thumbnails-m", container: "taboola-mid-article-thumbnails", placement: "Mid Article Thumbnails", target_type: "mix" });window._taboola = window._taboola || []; _taboola.push({flush: true}); TheHealthSite.com is India's fastest growing health information site with a team of health professionals and writers committed to providing unique, authentic, credible, well-researched, and timely information on topics related to physical and mental health. We immediately began quarantining. This can be seen in patients as a result of stress induced by the pandemic and battling the disease itself. Diagnosis of type 2 diabetes in a patient with acute sinusitis and COVID-19 in Colombia. If none of the above works for you, then I suggest you discuss with your GP the need to try a two-to-three week course of antibiotics in conjunction with nasal steroids. However, the variants are mutating and with them, the symptoms are also evolving. These include getting rest, drinking enough fluids, and using OTC medications. Ravindra Ganesh, M.B . Here are some other ways you can tell sinus infections apart from COVID-19 by: The symptoms of a sinus infection often come on suddenly. 2016 Dec;273(12):4281-4287. doi: 10.1007/s00405-016-4109-z. I am well past the isolation date. Ask the doctor: I am caring for my elderly father and his flatulence is causing me distress. YES NO. Ask Allison: I am almost 30 and have no friends. Emergence of Invasive Fungal Rhinosinusitis in Recently Recovered COVID-19 Patients. About 70% of the patients at the Neuro COVID-19 Clinic at Northwestern Memorial Hospital experience headaches associated with the coronavirus, Koralnik added. It presents itself as a respiratory or a skin infection and is mainly caused due to exposure to mucormycetes molds by breathing in the affected mold spores in air also referred to as a sinus (pulmonary) exposure. window._taboola = window._taboola || []; _taboola.push({ mode: "thumbnails-m", container: "taboola-mid-article-thumbnails", placement: "Mid Article Thumbnails", target_type: "mix" });window._taboola = window._taboola || []; _taboola.push({flush: true}); Recent studies reported an increased risk of heart failure in COVID-19 patients. Post-Covid Diet: Protein-rich foods can help recover from the loss of muscle. I have recovered from covid 19. The intitial infection has heightened how the brain and nerves are . Some symptoms like cough and loss of smell or taste may linger temporarily after COVID-19. As if the breathing complications associated with COVID-19 aren't worrisome enough, doctors are discovering another risk posed by the coronavirus: blood clots that can lead to life-threatening strokes, heart attacks and pulmonary embolism.. As COVID-19 traveled across Europe and hit hard in New York City, word began to spread of patients riddled with clots in their brain, hearts, lungs and . "It would be fair to speculate that new-onset headache would be related to the viral illness itself, since COVID tends to present with flu-like symptoms, McConnell said. The doctor further added, "A significant number of these patients are having back-breaking pain in the lower back and severe myalgia which is adding to the patient's woes.". Unusual Post-COVID Symptoms: Omicron Patients Can Suffer From THIS One Symptom Even After Recovery Unlike the Delta variant, Omicron doesn't affect the lungs. 800.8.COOPER (800.826.6737). and transmitted securely. Meher R, Wadhwa V, Kumar V, Shisha Phanbuh D, Sharma R, Singh I, Rathore PK, Goel R, Arora R, Garg S, Kumar S, Kumar J, Agarwal M, Singh M, Khurana N, Sagar T, Manchanda V, Saxena S. Am J Otolaryngol. Most sinus infections go away on their own without severe symptoms or complications. At six months on the national stage, however, little is known about the long-term course of COVID-19. Epub 2022 Oct 31. , neurologist and headache specialist with Norton Neuroscience Institute . These symptoms can be persistent, but come and go over time and have a negative impact on daily life. Invasive paranasal mucormycosis with peripheral eosinophilia in an immunocompetent patient. These include: But there are ways to relieve symptoms like a build-up of phlegm, and that's through deep breathing. A day later, we got the phone call. Headache. You may need antibiotics to treat your sinus infection. COVID-19 lasts for about a week or two depending on its severity and your overall health. One thing has become clear: While SARS-CoV-2 initially was labeled a respiratory virus . Advertising on our site helps support our mission. Though they may not always amount to the debilitating cases of long COVID-19 that can leave. A MAN had part of his face removed after he caught a rare flesh eating bug. Skin complications such as hemorrhagic bullae with intra-bullae blood clots and dissecting hematomas, Isolated herpetiform lesions, petechial rash. Treatment recommendations for long COVID headaches have been similar to how physicians treat other chronic headaches, McConnell said, which include adequate sleep, proper hydration, regular meals, and keeping stress to a minimum. Accessibility Being a water-soluble vitamin, you need to consume adequate amounts daily. Budesonide (a steroid inhaler), when given early after a COVID diagnosis, has been shown to reduce the likelihood of needing urgent medical care, as well as improving recovery time.. These strategies combined with physical activity or exercise and diet can be very helpful. Health is a serious topic and therefore we present you with engaging, straightforward and expert-reviewed content that helps you make the best decision for any health-related queries. 1998-2023 Mayo Foundation for Medical Education and Research (MFMER). 52% of patients said they had the constant sensation. Sinusitis is often accompanied by a toothache.H A sinus infection can also occur after exposure to allergens or irritants, such as pollen, pet dander, and cigarette smoke. We're available to shoot custom interviews & b-roll for media outlets upon request. In fact, there is often an allergic trigger to rhinosinusitis. Surgical treatment was restricted to patients with PCR negative results for COVID-19. By continuing to use this website, you accept and agree to such use of cookies. According to a 2020 study, patients with a pre-existing primary headache experience COVID headaches more frequently than those without. At present, more research is needed to understand how to treat post-COVID symptoms effectively. Many people develop a headache during the course of the infection that eventually goes away when they recover. It is always better to pay attention to the warning signs and symptoms. Learn about tips for relieving symptoms like inflammation, nasal congestion, and irritation. 2022 Oct 28;7(6):1780-1789. doi: 10.1002/lio2.956. Various factors can trigger this state which includes anxiety, stress and loneliness. Careers. Endoscopic, open, and combined approaches were utilized to eradicate infection. Copyright 2022 Indiadotcom Digital Private Limited. Secondly, you should try to reduce your contact with potential irritants such as pollen, mold, house dust mites (easier said than done), animal dander and feather in pillows or duvets. An individual may also develop ear pain as their only COVID-19 symptom. Many cases of COVID-19 may be mild or moderate. Sometimes i had swollen lips the other day the area around nose would pain and it has now been a continuous thing i also have a part of my write in a lining of the cheek to urge my upper jaw feeling to . (2021). Shortness of breath or difficulty breathing. CT sinus scans can also be performed if indicated in order to help firm up a diagnosis. COVID-19 can occur any time of the year. He joined the Ministry in April 2021 after several years working in corporate communications in the heavy equipment industry. Mucormycosis is a fungal infection that is seen in an immunocompromised host. A total of 36 patients with a mean age of 52.92 11.30 years old were included. IDCases. "It is a possibility that due to inflammatory mediators, this variant is causing more myalgia than any other variant post-recovery," the outlet reported. A New Study Suggests Paxlovid Could Prevent Long COVID, Long COVID May Manifest Itself in 4 Major Ways, Research Shows, What to Know About Organ Transplants and COVID-19, COVID-19 Increases Risk of Brain Conditions for 2 Years After Infection, Study Finds, What to Know About Parkinsons Disease and COVID-19, Characteristics of headache attributed to COVID-19 infection and predictors of its frequency and intensity: A cross sectional study, Daily persistent headache after a viral illness during a worldwide pandemic may not be a new occurrence: Lessons from the 1890 Russian/Asiatic flu, Evolution of neurologic symptoms in non-hospitalized COVID-19 "long haulers", Persistent headache after COVID-19: Pathophysioloy, clinic and treatment. These are usually just a sterile salt water mixture. Sinus infection is a condition in which the cavities around the nasal passages become inflamed. But there's more: discover your full benefits now. (2021). The hand on your tummy should move more than the hand on your chest, Breathe out through pursed lips like you're trying to whistle. Video transcript. Then, earlier this month, his bottom (adult) teeth started to feel loose, and eventually, one fell out. COVID-19 is an infectious disease that leads to a proinflammatory and prothrombotic state, resulting in both micro- and macrovascular thrombosis, and both arterial and venous thrombotic events. For example, someone who had migraines previously and then contracted the virus, may have more severe migraines after. Cleveland Clinic 1995-2023. People recovering from Omicron can experience the following: On the other hand, some people experience a mental and emotional toll from Covid. doi: 10.1016/j.idcr.2022.e01664. That's . This is more so for patients who stay alone for weeks in hospitalization or isolation, thus making insomnia a post COVID complication. Most of the COVID-19 patients recover completely except for some minor complications such as cough and shortness of breath. Is it OK to use a decongestant spray for weeks on end? From a runny nose to diarrhea, the Omicron variant can lead to several health complications. Laryngoscope Investig Otolaryngol. Complications like Myocarditis or an inflammation of the heart leads to it not pumping blood properly, causing the narrowing of the arteries, triggering high BP, and thus leaving one susceptible to a heart attack. Healthline Media does not provide medical advice, diagnosis, or treatment. Persistent headache after COVID-19: Pathophysioloy, clinic and treatment. On the fourth day, she. There are many more questions than answers, including about who is most at risk for post-COVID problems and how long the effects might last. The article is contributed by Dr Chetan Rao Vaddepally, Consultant Pulmonologist, Yashoda Hospitals Hyderabad. Experts estimate that 13 million Americans have long COVID. Consult online with detailed history for further evaluation. General Physician 11 yrs exp Nainital. This is a sleep disorder which affects the central nervous system where the sleep cycle of the person gets affected, leading to slower recovery. Indian J Otolaryngol Head Neck Surg. www.cdc.gov/coronavirus/2019-ncov/your-health . Methods: Learn about chronic sinusitis infections, including its treatment options and symptoms. Top 5 Symptoms of 'Long COVID'. Independent.ie. If you notice symptoms of COVID-19, get a COVID-19 test right away. If you have a medical emergency, contact 911 immediately. 2005-2023 Healthline Media a Red Ventures Company. Symptoms that would prompt Ear Nose and Throat (ENT) specialist referral include high fevers, severe headache, visual disturbance such as double vision, persistent bloody nasal discharge or unilateral (one side of the nose only) nasal symptoms.
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