Differential Diagnosis for 35-year-old Female with Sinus Pressure and Respiratory Symptoms
- Single most likely diagnosis:
- Acute bacterial sinusitis: The patient's symptoms of increasing sinus pressure, dry cough, sore throat, postnasal drainage, and thick green nasal drainage are consistent with acute bacterial sinusitis, especially given the lack of improvement with prednisone and the presence of thick green nasal drainage.
- Other Likely diagnoses:
- Viral upper respiratory infection (URI): The patient's symptoms of cough, sore throat, and postnasal drainage could still be consistent with a viral URI, and the lack of improvement with prednisone and over-the-counter medications does not rule out this diagnosis.
- Allergic rhinitis: Given the patient's history of seasonal allergies, it is possible that her symptoms are exacerbated by allergic rhinitis, especially if she is exposed to allergens.
- Acute exacerbation of GERD: The patient's history of GERD and symptoms of cough and sore throat could be related to an acute exacerbation of GERD, especially if stomach acid is refluxing into the throat and causing irritation.
- Do Not Miss diagnoses:
- Invasive fungal sinusitis: Although rare, invasive fungal sinusitis can present with similar symptoms and is a potentially life-threatening condition, especially in immunocompromised patients.
- Tuberculosis: TB can present with chronic cough, sore throat, and sinus symptoms, and is a critical diagnosis not to miss due to its public health implications and potential for severe morbidity and mortality.
- Lemierre's syndrome: This rare condition is characterized by a bacterial infection of the throat and jugular vein, and can present with symptoms similar to those of the patient, including sore throat and cough.
- Rare diagnoses:
- Sarcoidosis: This autoimmune condition can cause sinus symptoms, cough, and sore throat, although it is a less common diagnosis.
- Wegener's granulomatosis: This rare autoimmune condition can cause sinus symptoms, cough, and sore throat, as well as other systemic symptoms.
- Sinus cancer: Although extremely rare, sinus cancer can present with symptoms similar to those of the patient, including sinus pressure and nasal drainage.