Differential Diagnosis for 41-year-old Female with Persistent URI Symptoms
- Single most likely diagnosis:
- Chronic Sinusitis: The patient's symptoms of persistent nasal congestion, postnasal drainage, and yellow and blood-tinged nasal discharge, along with a frontal headache, are consistent with chronic sinusitis. The lack of improvement with over-the-counter medications and worsening symptoms over time also support this diagnosis.
- Other Likely diagnoses:
- Acute Bacterial Sinusitis: The patient's symptoms of worsening nasal congestion, yellow and blood-tinged nasal discharge, and frontal headache could indicate a bacterial infection of the sinuses.
- Allergic Rhinitis: The patient's symptoms of nasal congestion, postnasal drainage, and sore throat could be related to allergies, especially given her lack of response to over-the-counter medications.
- Viral Sinusitis: The patient's initial improvement and subsequent worsening of symptoms could indicate a viral infection of the sinuses.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.):
- Meningitis: Although unlikely, the patient's symptoms of headache and sore throat could be indicative of meningitis, a potentially life-threatening condition.
- Orbital Cellulitis: The patient's symptoms of frontal headache and nasal congestion could be related to an infection of the orbit, which can be serious and potentially vision-threatening.
- Cavernous Sinus Thrombosis: The patient's symptoms of headache and nasal congestion could be indicative of a blood clot in the cavernous sinus, a rare but potentially life-threatening condition.
- Rare diagnoses:
- Wegener's Granulomatosis: A rare autoimmune disorder that can cause sinusitis, nasal congestion, and other symptoms.
- Tumor of the Sinus or Nasal Cavity: A rare possibility that could cause persistent sinus symptoms and nasal congestion.
- Fungal Sinusitis: A rare infection that can cause sinusitis, especially in immunocompromised individuals.