Differential Diagnosis for 15-year-old Female with Nasal Congestion, Rhinorrhea, and Headache
- Single most likely diagnosis:
- Acute Sinusitis: The patient's symptoms of nasal congestion, rhinorrhea, bilateral ear fullness, sinus pressure, and discomfort with palpation over maxillary and frontal sinuses are consistent with acute sinusitis. The recent initiation of antibiotics for an early ear infection and the development of a headache worse with movement also support this diagnosis.
- Other Likely diagnoses:
- Acute Otitis Media: Although the patient was already started on antibiotics for an early ear infection, the persistence of ear fullness and the development of new symptoms could indicate a worsening or unresolved otitis media.
- Viral Upper Respiratory Infection: The patient's symptoms of nasal congestion, rhinorrhea, and sinus pressure could also be consistent with a viral upper respiratory infection, which may not require antibiotic treatment.
- Eustachian Tube Dysfunction: The patient's symptoms of bilateral ear fullness and dizziness with bending forward could be related to Eustachian tube dysfunction, which can be associated with upper respiratory infections.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.):
- Meningitis: Although the patient denies fever, shortness of breath, chest pain, nausea, or vomiting, the headache worse with movement could be a sign of meningitis, which is a medical emergency.
- Intracranial Abscess: The patient's symptoms of headache and sinus pressure could be consistent with an intracranial abscess, which is a rare but potentially life-threatening complication of sinusitis.
- Cavernous Sinus Thrombosis: The patient's symptoms of headache and sinus pressure could also be consistent with cavernous sinus thrombosis, which is a rare but potentially life-threatening complication of sinusitis.
- Rare diagnoses:
- Temporomandibular Joint (TMJ) Disorder: The patient's symptoms of ear fullness and dizziness with bending forward could be related to a TMJ disorder, although this is less likely given the other symptoms.
- Trigeminal Neuralgia: The patient's symptoms of headache and sinus pressure could be consistent with trigeminal neuralgia, although this is a rare condition and less likely given the patient's age and other symptoms.