Differential Diagnosis for a 17-year-old Male with Nasal Congestion, Rhinorrhea, Bilateral Ear Fullness, and Sore Throat
- Single most likely diagnosis:
- Viral pharyngitis: This is the most likely diagnosis given the patient's symptoms of sore throat, nasal congestion, rhinorrhea, and bilateral ear fullness, which are common presentations of a viral upper respiratory infection. The recent onset and the patient's past medical history of seasonal allergies also support this diagnosis.
- Other Likely diagnoses:
- Acute sinusitis: The patient's symptoms of nasal congestion, rhinorrhea, and bilateral ear fullness could be indicative of acute sinusitis, especially if the symptoms persist or worsen over time.
- Allergic rhinitis: Given the patient's history of seasonal allergies, it is possible that the current symptoms are an exacerbation of allergic rhinitis, particularly if the symptoms are related to specific allergen exposure.
- Infectious mononucleosis (re-infection or re-activation): Although the patient has a history of mononucleosis, it is possible for individuals to be re-infected or experience re-activation of the virus, which could present with similar symptoms.
- Do Not Miss diagnoses:
- Streptococcal pharyngitis: Although the patient denies a history of strep throat, it is crucial to consider this diagnosis due to its potential for serious complications, such as rheumatic fever or glomerulonephritis, if left untreated.
- Peritonsillar abscess: This is a rare but potentially life-threatening complication of tonsillitis that requires prompt recognition and treatment.
- Epiglottitis: Although rare, epiglottitis is a medical emergency that can present with severe sore throat, difficulty swallowing, and respiratory distress.
- Rare diagnoses:
- Lemierre's syndrome: A rare condition characterized by a bacterial infection of the tonsils and a subsequent thrombophlebitis of the internal jugular vein, which can present with severe sore throat and neck pain.
- Retropharyngeal abscess: A rare but potentially life-threatening condition that can present with severe sore throat, neck pain, and difficulty swallowing.