Differential Diagnosis for 42yo F with Sore Throat and Ear Pressure
- Single most likely diagnosis
- Acute sinusitis: The patient's symptoms of sore throat and bilateral ear pressure, along with the use of ibuprofen and cough drops for relief, suggest a possible postnasal drip or sinus infection causing referred pain to the throat and ears.
- Other Likely diagnoses
- Viral pharyngitis: Given the negative strep testing and monospot testing, a viral cause for the sore throat is possible, and the ear pressure could be related to Eustachian tube dysfunction.
- Allergic rhinitis: Seasonal or environmental allergies could cause postnasal drip, leading to sore throat and ear pressure.
- Tonsillitis: Although strep testing was negative, other bacterial or viral causes of tonsillitis could still be present.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Lemierre's syndrome: A rare but potentially life-threatening condition caused by a bacterial infection, typically Fusobacterium necrophorum, which can lead to sepsis and jugular vein thrombosis.
- Peritonsillar abscess: A complication of tonsillitis that can cause severe throat pain, fever, and difficulty swallowing, and requires prompt medical attention.
- Epiglottitis: Inflammation of the epiglottis, which can cause severe throat pain, difficulty swallowing, and respiratory distress, and is a medical emergency.
- Rare diagnoses
- Sjögren's syndrome: An autoimmune disorder that can cause dry mouth and throat, leading to sore throat and ear pressure.
- Thyroiditis: Inflammation of the thyroid gland, which can cause throat pain and ear pressure due to the gland's location.
- Nasopharyngeal carcinoma: A rare type of cancer that can cause sore throat, ear pressure, and nasal symptoms, although it is unlikely in this patient without other symptoms or risk factors.