Differential Diagnosis for 30-year-old Male with Ingrown Toenail Symptoms
- Single most likely diagnosis:
- Paronychia: This is an infection of the skin around the nail, which is consistent with the patient's symptoms of increased redness, pain, and swelling around the site of the previously removed ingrown toenail. The lack of improvement with Epsom salt soaks and Neosporin, and the worsening symptoms, suggest a bacterial infection.
- Other Likely diagnoses:
- Cellulitis: This is a bacterial skin infection that could explain the redness, pain, and swelling. The skin peeling around the area could be a sign of the infection spreading.
- Onychomycosis (fungal infection of the nail): Although the patient had an ingrown toenail removed, a fungal infection could still be present, causing inflammation and discomfort.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.):
- Osteomyelitis: This is a bone infection that could occur if the infection spreads from the skin to the bone. Although unlikely, it is a serious condition that requires prompt treatment.
- Sepsis: If the infection is severe and left untreated, it could lead to sepsis, a life-threatening condition.
- Rare diagnoses:
- Erythrasma: A bacterial infection that affects the skin folds, including the area around the toes. It could cause redness, swelling, and skin peeling.
- Kerion: A severe form of fungal infection of the scalp or skin, which could potentially occur around the toenail area, although it is rare.