Differential Diagnosis
- Single most likely diagnosis
- Allergic rhinitis: The patient's symptoms of sinus congestion and non-productive cough, along with the lack of fever, aches, and cough, suggest an allergic etiology. The fact that he has been given allergy medications without relief does not rule out this diagnosis, as it may indicate inadequate treatment or the need for further evaluation.
- Other Likely diagnoses
- Viral upper respiratory infection (URI): Although the patient's mother denies fever and aches, a viral URI could still be present, especially given the duration of symptoms.
- Sinusitis: The patient's symptoms of sinus congestion and non-productive cough, along with the lack of response to over-the-counter medications, suggest possible sinusitis.
- Eustachian tube dysfunction: The patient's muffled hearing, which increases in severity alongside his sinus congestion, suggests Eustachian tube dysfunction, which could be related to his sinus symptoms.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Bacterial sinusitis: Although less likely given the duration of symptoms and lack of fever, bacterial sinusitis could lead to serious complications, such as orbital cellulitis or intracranial abscess, if left untreated.
- Nasopharyngeal tumor: A rare but potentially life-threatening condition that could cause sinus congestion, cough, and hearing loss.
- Rare diagnoses
- Cystic fibrosis: A genetic disorder that could cause chronic sinusitis and respiratory symptoms, although it is less likely given the patient's age and lack of other symptoms.
- Immunodeficiency: A condition that could predispose the patient to recurrent or persistent infections, including sinusitis, although it is less likely given the patient's overall health and lack of other symptoms.
- Granulomatosis with polyangiitis (GPA): A rare autoimmune disorder that could cause sinusitis, hearing loss, and other symptoms, although it is less likely given the patient's age and lack of other symptoms.