What is the diagnosis for a 17-year-old female presenting with a 3-day history of pharyngitis (sore throat) characterized by a burning sensation, accompanied by nasal congestion, intermittent chills, ear fullness, and fatigue, after taking over-the-counter Benadryl (diphenhydramine) and NyQuil (acetaminophen and dextromethorphan)?

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Differential Diagnosis for 17-year-old female with sore throat

  • Single most likely diagnosis
    • Viral pharyngitis: This is the most likely diagnosis given the patient's symptoms of sore throat, nasal congestion, intermittent chills, ear fullness, and fatigue. The burning sensation in the throat and worsening symptoms over the past 3 days are also consistent with a viral infection. The patient's recent attendance at a prom, where she may have been exposed to others with similar illnesses, further supports this diagnosis.
  • Other Likely diagnoses
    • Bacterial pharyngitis (Strep throat): Although less likely than viral pharyngitis, bacterial pharyngitis is still a possible diagnosis, especially given the severity of the patient's symptoms. A rapid strep test or throat culture may be necessary to confirm this diagnosis.
    • Allergic rhinitis: The patient's symptoms of nasal congestion and ear fullness could be related to allergic rhinitis, especially if she has a history of allergies. However, the sore throat and chills are less typical of allergic rhinitis.
    • Sinusitis: The patient's symptoms of nasal congestion, ear fullness, and fatigue could be related to sinusitis, especially if she has a history of sinus infections.
  • Do Not Miss diagnoses
    • Epiglottitis: Although rare, epiglottitis is a life-threatening condition that requires prompt diagnosis and treatment. The patient's symptoms of sore throat and difficulty swallowing (if present) could be indicative of epiglottitis.
    • Peritonsillar abscess: This is a rare but serious complication of bacterial pharyngitis that requires prompt diagnosis and treatment. The patient's symptoms of severe sore throat and difficulty swallowing (if present) could be indicative of a peritonsillar abscess.
    • Infectious mononucleosis: This is a viral infection that can cause severe sore throat, fatigue, and fever. Although less likely, it is an important diagnosis to consider, especially in adolescents.
  • Rare diagnoses
    • Lemierre's syndrome: This is a rare but serious condition that occurs when a bacterial infection spreads from the throat to the jugular vein. The patient's symptoms of sore throat and fever could be indicative of Lemierre's syndrome, although it is a rare diagnosis.
    • Diphtheria: This is a rare but serious bacterial infection that can cause severe sore throat and respiratory symptoms. Although vaccination has made diphtheria rare in developed countries, it is still an important diagnosis to consider in patients with severe sore throat and respiratory symptoms.

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This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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