Differential Diagnosis
- Single most likely diagnosis
- Acute bacterial sinusitis: This is the most likely diagnosis given the patient's symptoms of nasal congestion, fever, and blood-tinged nasal drainage, especially after a recent ear infection. The mucosal swelling on the right side, which is the same side as the previous ear infection, further supports this diagnosis.
- Other Likely diagnoses
- Acute viral rhinosinusitis: Although the patient has been started on antibiotics, it's possible that her symptoms are due to a viral infection, which would not respond to antibiotics.
- Allergic rhinitis: The patient's symptoms of nasal congestion and swelling could be due to allergies, especially if she has a history of allergies or if the symptoms are seasonal.
- Nasal foreign body: Although less likely, a nasal foreign body could cause unilateral nasal swelling and discharge, and should be considered in the differential diagnosis.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Intracranial complications of sinusitis (e.g. abscess, meningitis): Although rare, these complications can be life-threatening and require prompt diagnosis and treatment.
- Orbital cellulitis: This is a serious infection that can cause vision loss and other complications if not treated promptly.
- Cavernous sinus thrombosis: This is a rare but potentially life-threatening complication of sinusitis that requires prompt diagnosis and treatment.
- Rare diagnoses
- Wegener's granulomatosis: This is a rare autoimmune disorder that can cause sinusitis and other symptoms, but is unlikely in this patient given the lack of other systemic symptoms.
- Nasal tumor: A tumor in the nasal cavity could cause unilateral nasal swelling and discharge, but is unlikely in this patient given her age and lack of other symptoms.