Differential Diagnosis for 26-year-old Female with Respiratory Symptoms
- Single most likely diagnosis
- Acute Sinusitis: The patient's symptoms of nasal congestion, rhinorrhea, postnasal drainage, productive cough, and right-sided sinus pressure are consistent with acute sinusitis, which is often caused by a viral or bacterial infection. The initial presentation of allergy-like symptoms that progressed to sinus pressure and discomfort also supports this diagnosis.
- Other Likely diagnoses
- Allergic Rhinitis: Although the patient's symptoms have evolved, the initial presentation of what she thought were allergy symptoms could still indicate an allergic component, especially if she has a history of allergies.
- Viral Upper Respiratory Tract Infection (URTI): The symptoms of nasal congestion, rhinorrhea, and productive cough could also be part of a viral URTI, which is very common and often self-limiting.
- Pharyngitis: The irritation under the tongue and the mention of a slightly swollen vein could suggest pharyngitis, possibly caused by a viral or bacterial infection.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Lemierre's Syndrome: Although rare, this condition involves a bacterial infection of the throat that can lead to sepsis and jugular vein thrombosis. The patient's complaint of irritation under the tongue and a swollen vein could be indicative of this serious condition.
- Peritonsillar Abscess: This is a serious complication of tonsillitis that can cause severe throat pain, difficulty swallowing, and fever. The patient's symptoms of irritation under the tongue could be related to this condition.
- Rare diagnoses
- Wegener's Granulomatosis (Granulomatosis with Polyangiitis): This is a rare autoimmune disorder that can cause sinusitis, cough, and other respiratory symptoms, but it would be an unusual diagnosis in this context without other systemic symptoms.
- Sarcoidosis: This condition can cause sinusitis and other respiratory symptoms, but it is relatively rare and would typically be associated with other systemic symptoms or findings on imaging studies.