Differential Diagnosis for 24-year-old Pregnant Female
- Single most likely diagnosis
- Sinusitis: The patient's symptoms of nasal congestion, increased sinus pressure, ear fullness, and thick green nasal drainage are consistent with a diagnosis of sinusitis. The onset of these symptoms approximately 2 weeks after the initial head trauma and the absence of severe neurological symptoms suggest a non-traumatic cause.
- Other Likely diagnoses
- Post-traumatic headache: The patient's history of head trauma and subsequent development of intermittent headaches, particularly in the evening, could suggest a post-traumatic headache. However, the absence of severe neurological symptoms and the delayed onset of sinus symptoms make this less likely.
- Eustachian tube dysfunction: The patient's symptoms of ear fullness and tinnitus could be related to Eustachian tube dysfunction, which can be caused by nasal congestion and sinus pressure.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Epidural hematoma: Although the patient denies loss of consciousness and has no severe neurological symptoms, an epidural hematoma is a potentially life-threatening condition that can occur after head trauma. The delayed onset of symptoms does not rule out this diagnosis.
- Meningitis: The patient's symptoms of headache and nasal congestion could be consistent with meningitis, particularly if the head trauma caused a cerebrospinal fluid leak. The absence of fever and severe neurological symptoms makes this less likely, but it is still a critical diagnosis to consider.
- Rare diagnoses
- CSF leak: A cerebrospinal fluid leak could occur after head trauma and cause symptoms such as nasal congestion and drainage. However, this diagnosis is less likely given the absence of severe neurological symptoms and the patient's overall clinical presentation.
- Temporomandibular joint (TMJ) disorder: The patient's symptoms of ear fullness and tinnitus could be related to a TMJ disorder, which can be caused by trauma to the jaw or head. However, this diagnosis is less likely given the patient's overall clinical presentation and the absence of jaw pain or clicking.