Differential Diagnosis for 77-year-old Male with Rhinorrhea and Nasal Crusting
- Single most likely diagnosis:
- Allergic Rhinitis: The patient's symptoms of rhinorrhea, redness, and crusting around the nose, particularly after starting a new facemask for sleep apnea, suggest an allergic reaction to the mask or its materials. The clear drainage and lack of fever also support this diagnosis.
- Other Likely diagnoses:
- Viral Rhinitis: The patient's symptoms of rhinorrhea and crusting could be due to a viral upper respiratory infection, which is common in the general population.
- Irritant Rhinitis: The new facemask could be causing irritation to the nasal passages, leading to rhinorrhea and crusting.
- Bacterial Rhinitis: The patient's symptoms of crusting and redness around the nose could be due to a bacterial infection, particularly if the warm compresses are introducing bacteria into the nasal passages.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.):
- Nasal Septal Perforation: The patient's use of a new facemask and subsequent nasal crusting could be causing pressure on the nasal septum, potentially leading to a perforation.
- Invasive Fungal Sinusitis: Although rare, this diagnosis is important to consider in immunocompromised patients, and the patient's age and sleep apnea put him at higher risk.
- Sjögren's Syndrome: This autoimmune disorder can cause dryness and crusting in the nasal passages, and although rare, it is important to consider in patients with persistent symptoms.
- Rare diagnoses:
- Granulomatosis with Polyangiitis (GPA): This autoimmune disorder can cause nasal crusting and destruction, although it is rare and typically presents with other systemic symptoms.
- Nasal Tuberculosis: This rare infection can cause nasal crusting and destruction, although it is typically associated with other systemic symptoms such as fever and weight loss.