Differential Diagnosis for 2 Weeks Sore Throat in a 16-year-old Male with Negative Strep Test
- Single Most Likely Diagnosis
- Viral pharyngitis: This is the most likely diagnosis given the negative strep test and the duration of symptoms. Most sore throats in adolescents are caused by viral infections, which can last for several weeks.
- Other Likely Diagnoses
- Infectious mononucleosis (mono): Caused by Epstein-Barr virus, mono can present with a prolonged sore throat, fever, and fatigue. The negative strep test does not rule out mono.
- Acute sinusitis: Sinus infections can cause throat pain and can be a consideration in patients with a prolonged sore throat.
- Allergic rhinitis: Postnasal drip from allergies can irritate the throat, causing a sore throat that lasts for weeks.
- Do Not Miss Diagnoses
- Lemierre's syndrome: A rare but potentially life-threatening condition caused by a bacterial infection of the throat, which can lead to sepsis and jugular vein thrombosis. Although unlikely, it's crucial to consider due to its severity.
- Peritonsillar abscess: A complication of tonsillitis that can cause severe throat pain and fever. Prompt diagnosis and treatment are necessary to prevent complications.
- HIV infection: Initial presentation of HIV can include a sore throat, and although rare, it's a critical diagnosis not to miss due to its long-term implications.
- Rare Diagnoses
- Tuberculosis (TB): Although rare in adolescents, TB can cause a chronic sore throat. It's essential to consider in patients with risk factors or exposure history.
- Toxoplasmosis: A parasitic infection that can cause a sore throat, although this is more common in immunocompromised individuals.
- Cytomegalovirus (CMV) infection: CMV can cause a mononucleosis-like syndrome, including a sore throat, but this is less common than EBV.