A child’s temperature without cough and snot: possible causes

Fever without cough and runny nose in an adult

A person immediately feels the onset of illness when the temperature rises.
Often a cough and other symptoms do not accompany this manifestation. Temperature is a consequence, a symptom of an inflammatory process in the body. It can be difficult to determine the cause, including because there are age-related characteristics of this process. An increase in body temperature without other symptoms indicates inflammatory processes in the body.

There are many reasons that cause elevated temperature in the absence of a runny nose or cough.

For example, a tick bite (plus body aches) may be accompanied by a similar temperature seven to ten days after being in nature. The female body increases its temperature above 37 degrees during ovulation.

Also, its slight rise can occur at the beginning of pregnancy (first trimester), during the menstrual cycle (second half).

Internal heat is accompanied by a sore throat (plus a sore throat after a few days). Often a manifestation of appendicitis is a temperature of 37 - 38 degrees, not accompanied by other symptoms.

Its rapid rise is caused by infections (ARVI), the source of which are viruses. The course of the disease may not be accompanied by a cough or runny nose.

The only symptom of ailments such as inflammation of the bladder or kidneys may be fever.

A cyst breakthrough is manifested by a temperature increase when fluid flows out of the tumor, causing inflammation and peritonitis. This can be caused by visiting a bathhouse, sudden physical activity, etc. Often the temperature rises to 37 - 37.5 degrees. and lasts a long time (during the day) when there is a disease of vegetative-vascular dystonia.

Additionally, general weakness, increased rhythm of cardiac activity and breathing, headaches, and heat-cold changes in thermoregulation are felt. A feeling of heat in the body is a sign of a hidden infection.

It may be insignificant, which weakens vigilance, for example, a prolonged but low temperature during tuberculosis.

A similar indirect symptom can become a manifestation of the initial stage of anemia, intoxication, thyrotoxicosis, radiation exposure, etc.

In children, temperature abnormalities are observed without cold symptoms, often for other reasons. Parents should notice them by their behavior, appearance, and show due attention to the emerging temperature.

The child may not complain, maintain his appetite, and continue playing.

Painful conditions are caused by overheating by clothing (sun), overwork, change of environment (people, place), dehydration, stress, not yet adjusted thermoregulation of the body, etc.

They can be traumatic - burns, bruises, abrasions, sunstroke (heatstroke), frostbite. In everyday life, there are also, for example, overheated bath water, food poisoning, drug overdose, very hot food (drink), allergic reactions that cause fever in the body.

With allergies, for example, a skin rash, swelling, and itching of the body surface are additionally noted. The cause of fever can be infectious diseases (chickenpox, measles, scarlet fever, etc.), enlarged lymph nodes, diseases of the nervous system (encephalitis, meningitis, etc.).

), inflammation of the larynx (tonsillitis, diphtheria, etc.).

Taking drugs (vaccination), also of poor quality, can unbalance the body’s thermoregulation, which will manifest itself for about 3 days.

Inflammatory processes are caused by disorders of the gastrointestinal tract, the eruption of baby teeth, the consequences of a cold, and are accompanied by temperature abnormalities.

On the other hand, a similar reaction, but complicated by changes in temperature values, is caused by congenital pathology (defects) of the heart.

Such situations are accompanied by a sharp rise and then a drop in the thermometer reading to 37 degrees, which lasts for a long time. It is common for children to have damaged skin. The body's response to this is heat caused by the healing effect of the pyrogen that the body releases.

Physical activity also raises the temperature, but not more than 37.5 degrees, which is not maintained for long.

Kidney disease looks like something special, in which for a long time the temperature remains at thirty-seven degrees (not higher) and suddenly jumps sharply to 39 degrees.

There are many reasons for temperature imbalance in the body, but self-medication is not the answer. Objective data in the form of test results and the experience of doctors are needed to identify the causes. When an elevated temperature is observed for about three days, you should consult a doctor (possibly earlier).

The heat due to activity and physical exertion passes quite quickly. Sweating and rest restore temperature balance. There is no reason to worry here. In hot weather, the baby is dressed in loose clothes, a light hat is put on his head, and plenty of warm drinks are provided. Exposure to direct sunlight should be minimized as much as possible.

At any time, clothing should only keep the body warm. The child's psyche should be protected from feverish conditions by a regimen, selected games, and calm communication. Small children have a fever (up to 40 degrees).

) is caused by teething, which is accompanied by swelling in the mouth.

This is a reason for parents to pay attention and be patient (the doctor may, when necessary, prescribe an anti-inflammatory drug).

Parents should be patient, observant, expectantly active, and not take panic measures. Problems with the cardiovascular system are solved by early hardening (with consultation with a doctor) and adaptation. To eliminate the consequences of ARVI, the child’s body is strengthened with vitamin complexes. If you have diseased kidneys, you should undergo an ultrasound examination.

To eliminate the problem of an allergic reaction, it is enough to identify the allergen and exclude its contact with the baby. Instructions for use of any medications must be studied and the expiration date of the drug must be checked.

In circumstances where you have a sore throat, problems with stool, nausea, or gastrointestinal disorders, you should promptly visit a pediatrician.

Emergency help is resorted to when the child feels very unwell.

A conscious person who develops a fever or prolonged high temperature is required to visit a clinic. Take blood tests (general, leukocyte, hemoglobin, ESR), urine (protein), undergo fluorography.

Otherwise, there is a risk that the disease will become chronic. This is how sources of hidden infections, viruses, are identified.

For example, an inflammatory process in the genitourinary system (pyelonephritis, cystitis) is detected by protein in the urine above normal.

Based on the results of image processing, tuberculosis is detected. You should definitely take care of the health of your loved ones. Vegetative-vascular dystonia goes away with the elimination of stress, anxiety, sufficient sleep, and walks.

Qualified examination and treatment solve the problem. Sometimes it is enough to boost immunity so that the temperature becomes 36.6 degrees. You should adjust your lifestyle, diet, take a course of vitamins, and get enough sleep.

Why do you have a fever without a runny nose or cough?

The onset of the disease is often accompanied by an increase in temperature. Sometimes people complain that their temperature rises and their bones ache, but there is no cough or runny nose. Determining the cause of this phenomenon can be difficult, because each organism is individual. In addition, the course of the disease can manifest itself differently in an adult and in a child, and the symptoms differ.

Causes of temperature changes

A healthy person's body temperature is 36.6 degrees. However, throughout the day it can reach 37.

Mainly, a temperature without cough and runny nose at 39 °C indicates an inflammatory process in the body.

This could be an allergic reaction, infection, inflammation of the genitourinary system, etc. Only a specialist can accurately determine the type of illness.

It is worth noting that abnormally low temperatures often occur, which remain at 35-35.5 degrees. This happens due to general fatigue or weakened immunity. Complications of chronic diseases and stress can also be the cause. In any case, you should consult a specialist.

Diseases that cause fever

Infectious and purulent diseases: tuberculosis;
pneumonia;
abscess;
typhus;
diseases of the genitourinary system.

Endocrine:

Malaria.

Tumors.

Vegetovascular dystonia.

Immunologists around the world say: an increase in temperature indicates the body's ability to fight diseases. If the immune system is normal, then this process indicates that the body is able to resist the effects of viruses and infections.

Injuries and fractures

Often the human body reacts in this way to an injury.

An increase in body temperature is influenced by injury, fractures or sprains. A person may not pay attention to the bruise, but a response will begin in the body.

Sometimes a splinter in a finger can cause inflammation if it is not treated in time. Any foreign organism or object can affect a person’s well-being.

Therefore, if there is a feeling of heat but no cough, then you should carefully examine your body to see if there is any damage.

Taking medications

As a result of using antibiotics or taking substandard drugs, “drug fever” can occur. It usually ends after stopping the medication. True, an accurate diagnosis can be established only after a thorough examination of the patient and collection of all information about the course of the disease.

Physiological reasons

A condition where the temperature has risen, but there is no runny nose or cough, also occurs due to the following factors:

excess warm clothing;
dehydration in the heat without drinking the required amount of fluid;
frequent stressful situations.

The symptom may appear if a person has taken a very hot bath.

In addition, doctors note the following reasons:

frostbite or burn;
exhaustion and fatigue;
taking an overly hot bath;
intoxication of the body.

What to do when your child has a fever?

If your baby has a temperature of 38 degrees, then you should not panic, because this does not necessarily mean illness. In this case, parents should pay attention to his behavior and appearance.

Often this condition can occur due to overheating, fatigue or stress. It is possible that the child was injured or bruised.

If the fever does not go away for several days, and there are no obvious reasons, then it is best to make an appointment with a doctor.

When to see a doctor?

An elevated body temperature for no apparent reason may mean that inflammation has begun and the body is fighting the disease. Patients often buy antipyretics, antibiotics and other drugs on their own.

But you shouldn’t abuse them, because only a doctor knows in what case the pills should be used.

If the temperature does not drop for several days, it is recommended to contact a local physician or pediatrician, who, if necessary, will refer the patient for treatment.

Preventive recommendations

Because an increase in body temperature does not always mean that a person is sick, it is not worth giving any recommendations. And if there is an illness, then only a doctor can determine it and, based on the diagnostic results, prescribe treatment.

As for the prevention of colds, hardening will be useful; it also strengthens the body’s thermoregulation mechanism.

A proper diet, physical activity and healthy sleep will help boost your immunity and improve your health if you have a high or low temperature.

Source: https://InfoGorlo.ru/rinit/temperatura-bez-nasmorka-i-kashlya.html

How to treat cough with fever in adults and children?

Treatment for cold symptoms can be varied. Medicines used for these purposes fall into three categories:

soothing,
cough intensifiers - expectorants,
mukalytics - to thin sputum.

As a rule, the causes of cough in children lie in hypothermia or a viral infection concentrated in the lower or upper respiratory tract. Moreover, due to hypothermia, diseases of the nose and throat can develop. Infectious diseases often affect:

With any parallel illness, a cough and fever appear, which can have varying intensity and, accordingly, varying degrees of danger. It is worth noting that the lower the lesion occurs, the more difficult the course of the disease will be.

Due to hypothermia, the nasal mucosa, the back wall of the pharynx and the ring of the tonsils become inflamed. As a result, mucus drains from the nose into the larynx, causing it to become irritated. This is how a cough appears, the main task of which is to eliminate foreign substances from the larynx and trachea, infected surrounding mucus and microbes.

Consequently, doctors insist that in this case the cough is a protective reaction and can be left untreated for some time. Therefore, antitussive drugs and remedies are prescribed only when the cough is strong and dry, which prevents a person from breathing normally and resting during sleep.

Treatment of a persistent runny nose in a child Komarovsky

If the patient feels satisfactory with a cough and low fever (37°C), then he can do his usual activities. But during the illness, it is important to give up sports and physical activity.

At the same time, it is necessary not to overcool the body, as this can aggravate the progression of the disease. And the youngest patients should be provided with bed rest.

To prevent the cough from recurring, it is necessary to follow preventive measures. To this end, you need to strengthen the immune system in every possible way - harden yourself, take vitamins, give up bad habits and not come into contact with a person who has the flu and other colds.

High temperature without cough and runny nose is a sign of an inflammatory process

03.09.201631349

High temperature is the first sign of the development of an inflammatory process in the body. This is how the immune system reacts to pathogenic microbes.

In this case, the fever is accompanied by other symptoms characteristic of a particular disease.

However, if it is not accompanied by a cough, sore throat or runny nose, then the causes of this pathological process should be found out as quickly as possible and eliminated.

Elevated body temperature is a sign of illness

Causes of fever in adults

In an adult, body temperature can change its values throughout the day, reaching 37.4 degrees. However, most often an increase in this indicator indicates a pathological process in the body. The reasons for a body temperature of 37 degrees and above can be different: from an allergic reaction to a disease of the genitourinary system.

Let's consider the possible causes of high temperature without signs of viral infection in adults.

Inflammatory processes. Fever without cold symptoms may indicate the presence of a focus of inflammation in the body (in the gastrointestinal tract, respiratory tract, genitourinary system).
Infections of the genitourinary system. Pyelonephritis and cystitis are often asymptomatic. The only sign indicating an inflammatory process in the bladder or kidneys is an increase in body temperature to 37-38 degrees.
Vegetative vascular dystonia is a dysfunction of the autonomic nervous system. Periods of exacerbation of the disease may be accompanied by fever, fatigue, headaches, and sleep disorders.
Diseases of the circulatory and cardiovascular systems.
Allergic reactions.
Overdose or individual intolerance to certain medications (antibiotics, anesthetics, salicylates, antidepressants).
Pulmonary tuberculosis. An infectious lung disease in the early stages is asymptomatic. The only sign indicating damage to the lungs by microbacteria is a sharp change in temperature during the day.
Mechanical damage to the skin and bones (bruises, fractures).
Benign and malignant tumors.
Autoimmune diseases (rheumatoid arthritis, polyarthritis, allergic vasculitis).
Angina. The disease begins with a sharp rise in temperature. The appearance of the main symptoms of sore throat (acute pain and sore throat) occurs on the 2-3rd day.
Infectious endocarditis resulting from previous sore throat or flu.
Meningococcal infection in the first stages develops asymptomatically. The only sign indicating an acute infectious disease is fever.
Dysfunction of the hypothalamus, the brain center that regulates temperature in the body.
An elevated temperature without cold symptoms in an adult may be the result of stress or severe emotional distress.
A fever without symptoms in an adult may indicate infection with Plasmodium parasites (malaria). The risk group includes people who often visit hot countries in Asia and Africa.
In women, slight temperature fluctuations (up to 37.1 - 37.5 degrees) are observed during the period of ovulation.

Normal human body temperature is known to be 36.6 C

Causes of elevated temperature in children

Children often have a fever due to the development of viral or infectious diseases. This means that the child's immune system fights the effects of pathogens. As a rule, a viral infection in a child is accompanied by other symptoms. Your baby may have a cough, runny nose, pain or sore throat.

When a child shows the first signs of ARVI, parents should immediately contact a pediatrician and undergo treatment under his supervision.

If a child’s high fever is not accompanied by other cold symptoms, then parents should not begin treatment on their own.

The causes of this pathology can be different and incorrect therapy will only harm the baby.

Let's consider the possible reasons for the increase in temperature in children.

A high temperature in a child without cold symptoms may indicate overheating of the body. Small children do not tolerate heat well, and infants can overheat even in winter if they are dressed too warmly. Overheating of the body is very difficult to diagnose, because symptoms may hardly appear.
If the baby has a temperature of 37 - 38 degrees for several days, then parents should examine the baby’s oral cavity. Fever can be a natural reaction to teething.
If a child has a temperature of 39 without cold symptoms (cough and runny nose), parents should carefully examine the baby’s throat. If, upon examination of the oral cavity, a rash, redness or small ulcers are detected, you should immediately consult a doctor. Such symptoms indicate pharyngitis. Depending on the nature of the disease (viral or bacterial), the pediatrician will prescribe the correct therapy.
A child with a temperature of 38 degrees without cold symptoms may indicate a urinary tract infection (pyelonephritis, cystitis). Pyelonephritis in children is accompanied by fever, lack of appetite, pain in the lumbar region and abdomen. Cystitis manifests itself primarily in frequent and painful urination. The disease in children is accompanied by fever and abdominal pain.
If a child has a temperature of 39 for 5 days, this may indicate the development of roseola. Roseola is a childhood disease that most often affects children under 2 years of age. The disease begins acutely. The fever without other symptoms lasts 3-4 days. On day 5, a rash appears in the form of small pink spots.

Body temperature is above 38.5°C, the child experiences weakness, chills, and headache

An increase in temperature in children can be triggered by other factors: vaccination, allergic reaction, stress, individual intolerance to certain medications. In this case, parents need to quickly and correctly establish the causes of the pathology and eliminate them.

Is it possible to lower the temperature?

Therapists do not recommend lowering the temperature below 38.5 degrees. This indicator indicates the resistance of the immune system to pathogens.

If the fever is caused by a viral infection, then the patient must be provided with rest, warm drinks and fortified food.

If the fever is caused by other reasons, then you should immediately consult a doctor who will examine the body, diagnose the disease and prescribe the correct therapy.

Pediatricians also do not recommend giving children antipyretic drugs at temperatures below 38.5 degrees. During this period, the child must be given warm drinks, herbal decoctions, and fortified foods.

However, if during the day the baby’s condition has noticeably worsened, he has become lethargic, pale, irritable, then it is necessary to eliminate the fever.

Doctors recommend giving children antipyretics based on paracetamol or ibuprofen.

If a child’s temperature stays at 37.5 - 38 degrees for 5 days, this means that the child’s immune system is not able to cope with pathological processes in the body on its own. In this case, parents should contact a pediatrician who will prescribe the correct treatment.

During a fever, the following procedures should not be performed:

inhalation;
mustard wraps;
alcohol or vodka compresses;
wrapping (during the heat the body should breathe freely);
water procedures.

Source: https://nasmorkoff.ru/cold/vysokaya-temperatura-bez-kashlya-i-nasmorka-eto-priznak-vospalitelnogo-processa/

Infectious causes that caused an increase in temperature

Most often, in addition to elevated temperature, the child has other symptoms, but parents cannot immediately consider them. If you contact a pediatrician, he will immediately identify them and be able to accurately diagnose them. There are a lot of diseases that immediately appear in the form of high fever without snot and cough:

Throat infections. If the baby is still very small, he will not allow you to take a good look at his throat, so it will not be possible to immediately understand why the temperature is high. But it can rise with several throat infections: acute pharyngitis, herpangina, sore throat. If a child has a sore throat, then you need to urgently start taking antibiotics, but if you have herpangina, you don’t need to take them. Pharyngitis can be of two types: infectious and bacterial, and each has its own specific course of treatment.
Acute stomatitis. With this disease, in addition to fever, apathy towards food may also be observed. If you look into your child's mouth, you may notice ulcers or blisters. If all these symptoms exist, then you urgently need to call a doctor at home, and while he is on his way, you can rinse your mouth with Furacilin, sage or chamomile.
Acute otitis. Pain in the ear often leads to an increase in body temperature. A small child will not be able to tell what is hurting him, but his ear grabbing, refusal to eat and whims can tell his parents what the reason is.
Sudden exanthema. This disease is observed in children aged 9 months to 2 years. The first symptom is a high temperature from 38 to 40 degrees, and it lasts about 5 days. The lymph nodes in the neck or back of the head may also become inflamed. After 5 days, the temperature drops, but the whole body is covered with a rash, which, without treatment, also goes away on its own after 4-5 days.
Urinary tract infection. In this case, the child experiences a high temperature. In rare cases, swelling of the lower extremities may occur, and urination may be frequent and painful. An accurate diagnosis can be made after a general urine test.

Fever without cough or runny nose

When a person begins to develop hyperthermia, this indicates that some pathological process is occurring in the body. At the initial stage of viral infectious diseases, as a rule, there is a fever without a cough or runny nose. An increase in general body temperature is a protective reaction of the body.

At a temperature of thirty-eight point five degrees, the body begins to produce interferon, which fights pathogens. But in order to establish the exact cause of the elevated temperature, especially if it occurs in a small child, you must definitely consult a doctor and undergo an examination.

Fever without cough or runny nose

For what reasons can a fever begin?

In humans, an increase in temperature can occur for many reasons, the most common of which is respiratory viral diseases such as laryngitis, tracheitis, bronchitis. However, during all these illnesses, a person soon begins to cough and his nose is stuffy. Factors leading to fever, but without nasal congestion and cough, can be:

sun or heatstroke;
overheating due to excess clothing;
dehydration in hot weather;
trauma - bruise, fracture, burn;
poisoning with stale food;
any inflammatory process.

In young children, the temperature can also rise during teething or even from severe physical or emotional fatigue. To determine the cause of a fever that is not accompanied by a cough and runny nose, it is necessary to be examined by a doctor who will compare all the accompanying symptoms, make a diagnosis and prescribe appropriate treatment.

When can you lower your temperature?

Most people, when their temperature rises, immediately try to lower it, but doctors do not recommend doing this until the mark on the thermometer reaches thirty-eight point five degrees.

The fact is that only at this temperature and above does the body begin to fight pathogenic microorganisms.

By bringing down the temperature to thirty-seven point five, or thirty-eight degrees, a person only prevents the body from fighting infection and prolongs the period of illness.

However, there is a group of patients in whom it is necessary to eliminate even a slight increase in temperature. Some children react very hard even to thirty-seven and two, they begin to have convulsions, and during convulsions the brain is less enriched with blood and oxygen. Hyperthermia should not be allowed in such children; as soon as the temperature begins to rise, it must be brought down immediately.

What not to do when you have a fever

Regardless of whether there is a runny nose and cough at a fever, there are restrictions that will help not lead to even greater hyperthermia and complications. So, when a person has an elevated body temperature, doctors strongly do not recommend:

warm your feet in hot water;
treated with mustard plasters;
make compresses using alcohol or alcohol tinctures and solutions;
carry out inhalations (steam or using a nebulizer);
smear the chest and back with warming ointments;
put cans.

For babies with a fever, it may be dangerous to wipe with water and vinegar for two reasons:

When using a solution that is too concentrated, acetic acid enters the child’s bloodstream through the skin (the same applies to rubbing with alcohol), which can cause poisoning;
Vinegar is highly volatile, and as it evaporates, it carries away the child’s body heat, which leads to a very sharp drop in temperature and causes vasospasm. Normally, body temperature should drop by half a degree or one degree per hour. That is, if the temperature was thirty-eight and five, and an hour later it dropped to thirty-eight, then this is very good.

When a fever begins without a cough or runny nose, it is important to identify the cause of the ailment in time and begin to fight it.

What to do if you have a fever

If a child or an adult feels normal when the temperature rises even to thirty-eight degrees, then it is possible not to bring it down, so the body will cope with the infection faster.

But if you feel unwell, severe lethargy, irritability, loss of appetite, etc., even a small increase should be reduced.

If we are talking about a child under one year old, then if the body temperature rises to thirty-eight degrees, especially if there is no runny nose or cough, you should call an ambulance.

If your child has a fever

If the baby’s hyperthermia began after he ran too hard, it will quickly subside on its own. In order to alleviate the child’s condition during fever and speed up his recovery, parents need to:

Give your baby to drink as much as possible. As the temperature rises, the body loses a lot of moisture; in order to prevent water-electrolyte imbalance and dehydration, it is necessary to replenish the lost fluid. Warm drinks - compotes and teas - help with this better. You can brew chamomile tea as it has an anti-inflammatory effect. It is worth remembering that raspberry tea should be given to the baby only at low temperatures, since raspberries have a strong diaphoretic effect, as a result of which the temperature drops quickly, but the body loses a lot of moisture.
Ventilate the children's room and do wet cleaning at least twice a day. Dust and dry heavy air make it difficult for a child to breathe and prevent the removal of germs from the body. Flying in the air, they again enter the baby’s body during breathing. A humidifier will be a useful thing when treating a fever.
Walk outside away from healthy children at temperatures up to thirty-seven and five degrees, but provided that the child is not lethargic and feels well.

If the temperature rises, then it is necessary to give the baby an antipyretic drug. In pediatrics, medications based on ibuprofen and paracetamol are allowed. Ibuprofen (Nurofen, Ibufen, Bofen, etc.

) can be given to children every eight hours, paracetamol (Panadol, Tylenol, Calpol, etc.) is given no more often than once every four hours.

Antipyretic drugs such as Acetylsalicylic acid (Aspirin), Analgin and medications containing these active ingredients are contraindicated for children.

If an adult has a fever

If an adult has hyperthermia, he should consult a doctor, undergo general urine and blood tests, and also undergo fluorography. This way you can diagnose acute diseases that, without treatment, become chronic, as well as pulmonary tuberculosis. The principles of reducing high fever in adults are the same as when treating children, but more medications can be taken than in children.

If the temperature without a cough and without a runny nose in a child or adult patient does not decrease within three days and does not go away completely on the fifth day, then this indicates the addition of a bacterial infection. In this case, you cannot do without taking antibiotics. Only a doctor should prescribe them and select the dosage after a complete examination and interpretation of the patient’s tests.

(56 4,70 out of 5)

Source: https://NetGaymorita.ru/temperatura-bez-kashlya-i-bez-nasmorka.html

Types of cough

There are these types of cough:

An acute cough can last up to 21 days, and a chronic cough can last more than 3 weeks. During the year it appears several times, while other cold symptoms do not appear.

Dry (non-productive) and wet (productive) cough is a protective reaction of the body, the main task of which is to free the airways from irritating factors (smoke, dust, mucus, foreign bodies).

When sputum is not coughed up, such a cough is called unproductive, and if it is coughed up, it is called wet. When coughing, the temperature can rise to 37, 38 and 39 degrees. Breathing problems and loss of appetite may also occur.

In addition, the causes of cough are:

non-infectious (asthma, foreign body in the respiratory tract),
infectious.

But to establish the exact cause, you need to consult a doctor who can reliably determine the factors causing cough.

Moreover, to clarify the diagnosis, the therapist can refer the patient to an allergist, otolaryngologist and cardiologist.