I understand how frustrating chronic throat irritation and fatigue can be. Your elevated IgE level of 495 IU/mL strongly suggests an allergic response, and since your sinus imaging is clear, allergic rhinitis is a very likely cause. Fexofenadine (Allegra) is an excellent, non-drowsy antihistamine that is highly appropriate for these allergy-driven upper airway symptoms. While it will help, some patients also benefit from a nasal steroid spray for complete relief. Additionally, managing your allergies may help improve your sleep and ease your fatigue. I recommend discussing these results with an allergist to find the best combination for you.

. When standard antihistamines and leukotriene receptor antagonists aren't enough, the next recommended step is often a biologic medication called omalizumab, which is very effective at calming the immune system. Another option your doctor might consider is an immunosuppressant medication called cyclosporine. A brief course of oral corticosteroids can also help manage sudden flare-ups. I highly recommend discussing these next-line therapies with your allergist or dermatologist to find the safest, most comfortable path forward for you.

It is quite common to experience acid reflux and nausea during COVID-19 recovery, as the virus can temporarily affect your digestive system. However, your symptoms could also be linked to your medications. Amrox LS (containing ambroxol and levosalbutamol) can sometimes cause stomach irritation, and Allegra (fexofenadine) can occasionally lead to mild nausea, even though Normaxin RT (rabeprazole and itopride) is meant to reduce acid and support digestion. Taking these together, especially right after breakfast, might trigger this burning sensation. Please consult your prescribing doctor to see if adjusting the timing of your doses helps.

Since it has lasted four days without improvement despite taking azithromycin, it is very important to see a doctor for an in-person evaluation. Because azithromycin is an antibiotic, it won't help if your infection is viral, such as mononucleosis, or if it is caused by a resistant bacterial strain. A healthcare provider can perform a quick throat swab to check for strep throat. To help you feel more comfortable in the meantime, you can gargle with warm salt water and take over-the-counter pain relievers like ibuprofen or acetaminophen.

Yes, your symptoms strongly suggest an allergic reaction. Since warm saltwater rinses haven't provided enough relief, taking Allegra (fexofenadine) is a very reasonable next step. It is a non-drowsy antihistamine that helps block the histamines triggering your sneezing. Please follow the package instructions, and if your symptoms don't improve or if you develop new symptoms, it would be wise to consult your doctor.

Since topical treatments and corticosteroid creams haven't worked?and steroids can sometimes actually worsen fungal infections?the standard clinical approach is to transition to prescription oral antifungal tablets, such as terbinafine or itraconazole. These medications work from the inside out to effectively eliminate the fungus from your face, stomach, and thighs. I highly recommend visiting a healthcare provider or dermatologist so they can safely prescribe the correct oral medication and monitor your progress.