One of the most common questions that I get has an ear nose and throat specialist, often from friends and family, is how to tell the difference between nasal allergies and an infection. Although there is overlap between the symptoms, there are a few rules of thumb to help you tell the difference. Allergic symptoms may start gradually or suddenly, and include sneezing, nasal congestion, clear nasal drip, postnasal drip, itchy ears, eyes, throat and nose, fatigue, and sometimes cough. There are many ways of treating allergies, but those targeted at the allergic response can be grouped into one of three categories. Those are antihistamines (Claritin, zyrtec, benedryl), steroids (nasal sprays or oral), and leukotriene inhibitors (singulair). Decongestants such as Sudafed, topical decongestant such as Afrin, and mucous thinners such as mucinex often help with her symptoms.
An infection will include the congestion, postnasal drainage, and fatigue but will also cause discolored nasal discharge, sore scratchy throat, sinus pain, cough, and fever. Most nasal and sinus infections are viral for the first 5 to 7 days. We worry about bacterial infections when you continue to have these symptoms for more than seven days, and especially if you get better for a few days, and then develop the symptoms of an infection again. This is when it is appropriate to start antibiotic therapy.
Christopher Thompson, MD
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