What are a runny nose and sore throat?
A runny nose, nasal congestion, and sore throat are common symptoms of upper respiratory tract infection (the common cold), but their underlying causes are diverse, and treatments vary significantly. It is crucial to identify the cause, which could be the common cold, influenza, COVID-19, sinusitis, hay fever, streptococcal infection, tonsillitis, or postnasal drip, among others.
At our clinic, we pinpoint the cause through rapid tests (for influenza, COVID-19, and strep throat) and visual examination and blood tests, and then provide treatment tailored to the symptoms and cause.
Self-medicating with over-the-counter drugs has its limitations.
Over-the-counter cold medicines often contain multiple ingredients, leading to the intake of unnecessary components. It is more effective and results in fewer side effects to prescribe appropriate medications individually based on the cause.
Main Causes of Illness
| Condition | Characteristic Symptoms | Main Treatment |
|---|---|---|
| Common cold (Acute nasopharyngitis) | Runny nose, sneezing, mild sore throat, low-grade fever | Symptomatic treatment (antihistamines, expectorants, etc.) |
| Influenza | Sudden high fever, joint pain, general fatigue, sore throat | Rapid test → Antiviral drugs for influenza |
| COVID-19 | Sore throat, fever, loss of taste, fatigue | Antigen test → Antiviral drugs (if indicated) |
| Streptococcal infection | Severe sore throat, rash, red tongue, fever | Rapid test → Penicillin-based antibiotics for 10 days |
| Acute tonsillitis | Severe pain deep in the throat, difficulty swallowing, swollen tonsils, white patches | Antibiotics, severe cases require IV drip |
| Sinusitis (Acute/Chronic) | Yellow-green nasal discharge, pain in cheeks/forehead, postnasal drip | Antibiotics, nasal irrigation; chronic cases referred to ENT |
| Hay fever (Allergic rhinitis) | Clear, watery nasal discharge, continuous sneezing, itchy eyes | Antihistamines, nasal steroids |
| Perennial allergic rhinitis | Nasal symptoms from dust mites/house dust | Antihistamines, sublingual immunotherapy |
| Cough variant asthma/Atopic cough | Persistent cough, allergic predisposition | Inhaled steroids, bronchodilators |
Conditions Suspected Based on Nasal Discharge Color and Consistency
| Nasal Discharge Consistency | Suspected Condition |
|---|---|
| Clear, watery | Early stage of common cold, allergic rhinitis, cold-induced rhinitis |
| White, viscous | Mid-stage of common cold, chronic rhinitis |
| Yellow, green | Bacterial sinusitis, chronic sinusitis (empyema) |
| Mixed with blood | Nosebleed, nasal cavity tumor (requires detailed examination) |
| Postnasal drip (flows down the throat) | Sinusitis, allergic rhinitis |
If yellow-green nasal discharge continues for more than 10 days, seek medical attention.
Nasal discharge from a common cold usually resolves spontaneously within 7-10 days. If yellow-green nasal discharge continues for more than 10 days or if you experience pain in your cheeks or forehead, it may be bacterial sinusitis, which requires antibiotic treatment.
Conditions Not to Miss with a Sore Throat
Streptococcal Infection
- Severe sore throat, fever (38℃ or higher), red tongue (strawberry tongue), rash on the trunk
- Characterized by little to no runny nose or cough
- Common in children but also occurs in adults
- Diagnosed with a rapid test (5-10 minutes)
- It is crucial to complete the 10-day course of antibiotics (to prevent rheumatic fever and acute glomerulonephritis)
Acute Tonsillitis/Peritonsillar Abscess
- Tonsils are red and swollen, sometimes with white pus (tonsil stones)
- Difficulty swallowing, fever, swollen lymph nodes
- Peritonsillar abscess can lead to trismus (difficulty opening mouth) and speech impediment (ENT emergency)
- Antibiotic treatment; severe cases require intravenous drip and hospitalization
Infectious Mononucleosis (EB Virus)
- Common in young adults
- Persistent sore throat, general fatigue, swollen lymph nodes, fever
- Rash may appear with antibiotics (especially amoxicillin)
- Diagnosed by blood test, treatment is mainly symptomatic
Other Important Conditions Not to Miss
- Retropharyngeal abscess: accompanied by respiratory distress
- Acute epiglottitis: rapid progression, respiratory distress, difficulty swallowing (emergency)
- Oral/pharyngeal cancer: persistent discomfort, history of smoking
- Thyroiditis: anterior neck pain + fever
About Sinusitis (Chronic Sinusitis)
Sinusitis is an inflammation of the cavities around the nose (paranasal sinuses). It is categorized into acute and chronic, with different treatment approaches.
Acute Sinusitis
- Often develops after a cold
- Yellow-green viscous nasal discharge, pain in cheeks/forehead, fever
- Headache that worsens when bending forward
- Treatment: antibiotics (7-14 days), nasal irrigation, antipyretics/pain relievers
Chronic Sinusitis
- Lasts for more than 3 months
- Persistent nasal congestion, postnasal drip, reduced sense of smell
- May be accompanied by nasal polyps
- Treatment: low-dose long-term macrolide therapy; endoscopic surgery by an ENT specialist may be necessary
For persistent nasal symptoms or anosmia, refer to an ENT specialist.
If chronic sinusitis, nasal polyps, or anosmia are suspected, endoscopic examination and CT scan by an otolaryngologist are necessary. Our clinic provides initial diagnosis and medication, and refers patients to specialized medical institutions as needed.
Distinguishing Allergic Rhinitis and Hay Fever
| Item | Common Cold | Allergic Rhinitis |
|---|---|---|
| Nasal discharge | Gradually viscous | Clear and watery |
| Sneezing | Occasional | Continuous |
| Itchy eyes | Almost none | Strong (especially hay fever) |
| Fever | Often present | None |
| Duration | 1-2 weeks | Several weeks to months, same time every year |
| Sore throat | Strong to moderate | Mild |
Examination and Tests at Our Clinic
Key Points for Interview
- Onset, duration, and changes from initial symptoms
- Presence of fever, color, and consistency of nasal discharge
- Severity and location of throat pain
- Presence of cough, phlegm, or ear pain
- Infection status of those around you, vaccination history
- Allergy history, seasonality
- Medical history, asthma, smoking history
Tests
| Test | Purpose |
|---|---|
| Influenza rapid test | Type A/B determination (15 min) |
| COVID-19 antigen test | COVID-19 determination |
| COVID-19/Influenza co-test | Simultaneous determination of both |
| Strep throat rapid test | 10-minute determination |
| Pharyngeal visual inspection | Check for tonsil swelling, white patches, pus |
| Blood test | Inflammation markers (WBC, CRP), bacterial/viral differentiation |
| Specific IgE (allergy test) | Identification of pollen, dust mites |
| View39 | Batch test for 39 allergens |
Treatment Options
Prescription Examples by Symptom
| Symptom | Prescription Example |
|---|---|
| Clear nasal discharge, sneezing | Antihistamines (fexofenadine, bilastine, etc.) |
| Nasal congestion | Nasal steroids (fluticasone, mometasone) |
| Viscous nasal discharge, postnasal drip | Carbocysteine, ambroxol |
| Sore throat (viral) | Acetaminophen, NSAIDs, lozenges |
| Sore throat (bacterial) | Antibiotics (amoxicillin, cefcapene, etc.) |
| Cough | Antitussives (dextromethorphan), expectorants |
Appropriate Use of Antibiotics
Cold ≠ Antibiotics
More than 90% of common colds are caused by viral infections, and antibiotics are ineffective. Unnecessary antibiotic use contributes to the development of drug-resistant bacteria. Our clinic's policy is to prescribe antibiotics only when bacterial infection is confirmed.
Consult Us for These Symptoms
- Runny nose or sore throat lasting more than 1 week
- Accompanied by a fever of 38℃ or higher
- Persistent yellow-green nasal discharge with cheek/forehead pain
- Severe sore throat making it difficult to swallow
- Difficulty breathing or wheezing
- Continuous sneezing accompanied by itchy eyes
- Nasal symptoms occurring at the same time every year
- Symptoms not improving with over-the-counter medications
Self-Care in Daily Life
During Cold Symptoms
- Adequate hydration (water, hot water, oral rehydration solution)
- Humidification (50-60% humidity) to prevent throat dryness
- Nasal irrigation (with saline solution)
- Mask for moisturizing + droplet prevention
- Sufficient sleep and rest
- Warm, easily digestible meals
Measures for Allergic Rhinitis
- Pollen masks and glasses
- Brush off pollen from clothes and wash hands upon returning home
- Air purifier, HEPA filter
- Dry futons, wash sheets once a week
- Avoid carpets
Recommendation to Quit Smoking
Smoking directly damages the mucous membranes of the nose, throat, and bronchi, exacerbating and chronicizing symptoms. Quitting smoking improves both infection and allergy symptoms.
Features of Our Clinic's Nose and Throat Care
- Rapid tests for influenza, COVID-19, and strep throat available the same day
- Individualized prescriptions tailored to symptoms (more efficient than over-the-counter multi-symptom cold medicines)
- Supports sublingual immunotherapy (Shida Cure, Miticure) for allergic rhinitis
- Prompt referral to ENT specialists for chronic sinusitis, nasal polyps, and anosmia
- Antibiotic treatment and recurrence prevention guidance for streptococcal infections
- Appropriate use of antibiotics (prescribed only for bacterial infections)
- No appointment needed, same-day consultation OK / Open daily 9-21h / 1 minute walk from Jujo Station
It's important to know the cause, even for mild symptoms.
Even for the same "sore throat," treatment varies depending on the cause. Identifying the cause quickly allows for the shortest possible use of appropriate medication, leading to faster recovery.
