Possible Causes for My Boyfriend's Ongoing Congestion
My boyfriend, who is 26 years old and weighs 205 pounds, has been struggling with persistent nasal congestion for the past two months, and the condition seems to be worsening. Interestingly, he hasn't displayed any additional symptoms during this time. About a month ago, he received a 10-day course of amoxicillin after an urgent care visit, where the physician diagnosed him with sinusitis without conducting any tests. Unfortunately, this treatment did not provide any relief; in fact, I believe his condition has deteriorated. Since then, he has seen his primary care physician twice. During the first visit, he was given two nasal sprays. However, his cough has intensified and now has a noticeably chesty quality, contrasting with its previous dry nature. At his second appointment, the doctor prescribed him a course of prednisone, levofloxacin, and Mucinex. He has yet to start these medications as we are exploring other alternatives, particularly since no diagnostic tests have been performed to clarify the situation. The prescribed medications seem quite intensive. He has an appointment with an ear, nose, and throat (ENT) specialist in two weeks, but I am wondering if there are additional evaluations he should consider in the meantime. Options like a sputum culture, chest X-ray, or a CT scan come to mind. His current insurance coverage is not the best, meaning that he would likely be responsible for most expenses out of pocket. Nevertheless, if there are quicker diagnostic methods available that could yield answers and help him on the road to recovery, I would greatly appreciate any recommendations on what examinations to prioritize. Regrettably, we haven't found the previous healthcare provider to be particularly helpful in this matter.
Answers (1)

9/13/2025, 5:50:36 PM
OpenHealth AI
Your boyfriend's ongoing nasal congestion and worsening cough over the past two months is understandably concerning, especially since previous treatments have not brought relief. With an upcoming ENT appointment, it's good to prepare and consider additional evaluations that could help clarify his condition sooner rather than later.
Main Points:
- Persistent congestion can stem from various underlying causes, including allergies, chronic sinusitis, or even asthma.
- Given the worsening cough and the chesty quality, further evaluation is prudent.
- It's essential to balance the need for diagnostics with the costs involved, especially with limited insurance coverage.
Explanation:
Nasal congestion lasting for two months, coupled with a new chesty cough, may suggest an ongoing respiratory issue. While sinusitis is one possibility, it's important not to overlook potential allergies, asthma, or even an infection not fully resolved by previous treatments. Since he’s already been on antibiotics without improvement, other diagnostics could provide more insight.
Prioritized Next Steps:
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Keep the ENT Appointment: This is a crucial step and could lead to specialized evaluations and targeted treatment options.
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Consider a Chest X-ray:
- Why: A chest X-ray can help rule out serious lung infections or other structural issues in the lungs, especially since the cough has become more pronounced.
- Cost Consideration: Check if this is covered under his insurance plan as outpatient imaging.
-
Sputum Culture:
- Why: If he is producing mucus with his cough, a sputum culture can identify bacterial infections or other pathogens that might not have responded to the amoxicillin.
- Cost Consideration: This is generally an outpatient test but check for coverage.
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Monitor Symptoms: Keep a detailed diary of his symptoms, including the nature of his cough, any triggers, and response to any medications he starts. This can be valuable information for the ENT specialist.
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Hydration and Humidification: Encourage him to stay hydrated and use a humidifier at home to ease congestion and improve breathing.
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Evaluate Allergies: If he experiences symptoms like itching, sneezing, or watery eyes intermittently, consider using over-the-counter antihistamines as a trial to see if they help with the congestion.
Overall, while awaiting the ENT appointment, focus on collecting information that may help guide the doctor during the visit. Stay proactive, and don’t hesitate to follow up on any concerning symptoms in the meantime. Your support in this process is valuable, and it's essential to advocate for the care he needs.
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