Headaches w/ facial edema

[kidluvinRN]

Good morning. I am looking for some advice or info. re: my 12 y.o.'s situation. He has had horrible headaches in the morning which improve over the day for the past week + he calls them "Throbbing" and also gets them when he gets up from sitting after a long period; for the last 4 days he has had periorbital edema upon awakening. Took one elevalted BP in the AM; but the rest WNL. He also has had a sore throat; afebrile for the past week.

Yesterday I took him to the pediatrician. He was strep +, but urine, BP WNL. They ordered a sinus CT; which I am still waiting for results. However, he has had no signs of sinus infection; no nasal drainage, tenderness, or congestion!!! Can you have a sinus infection without any signs? Needless to say I'm a bit worried and I am wondering should they have checked anything else? Any thoughts appreciated.

[Jolie, BSN]

Could this possibly be allergy related? My daughter has allergies which seem to peak in the fall. She gets migraine-like headaches when her allergies aren't well-controlled. She takes Zyrtec and uses Nasonex Spray daily, but the NP we see is considering adding Singular to the mix if her allergies get out of control this fall, as they have in the past.

Good luck to you. Hope your son feels better!

[BittyBabyGrower, MSN, RN]

Yes, there can be a chronic infection without a fever! My DD had something similar last year and it started with her allergies being really bad (on Flonase, Singular and Zyrtec). It is a chronic irritation that leads to an infection. On her CT her poor little head lit up like a lightbulb! The ENT had me add Sudafed every other day and that seemed to help She could take it every day because she would get a high heart rate and be off the wall. She was also placed on Augmentin for 3 weeks.

Hope he feels better soon!

[kidluvinRN]

Thanks for the replies; and yes he is starting to feel better. They started him on Augmentin for sinusitis. Is it just me or do other people completely lose their nursing instincts when it comes to their own children!?! I'm either "well you aren't bleeding, broken, don't have a fever, etc." or if there are actually symptoms of worry my mind jumps to worse case scenarios.