Differential Diagnosis for Left Nostril Pain and Swelling in a Lactating Female
- Single most likely diagnosis:
- Acute bacterial sinusitis: The patient's symptoms of nasal pain, swelling, and fever, especially after a recent upper respiratory infection (GI bug with nasal drainage), suggest a bacterial infection of the sinuses. The lack of improvement with conservative measures and the development of systemic symptoms like fever and headache further support this diagnosis.
- Other Likely diagnoses:
- Nasal furuncle or abscess: The initial assumption of a pimple inside the nose, followed by swelling and pain, could indicate a localized infection of the nasal vestibule, which is a common area for furuncles or abscesses to form.
- Allergic rhinitis: Although less likely given the acute onset and presence of fever, allergic reactions to environmental allergens (e.g., from camping) could cause nasal congestion, swelling, and discomfort.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.):
- Cavernous sinus thrombosis: This is a rare but potentially life-threatening complication of facial or sinus infections. The presence of fever, headache, and nasal symptoms could be indicative of this condition, especially if there are signs of orbital involvement or neurological deficits.
- Nasal septal abscess: An abscess of the nasal septum can lead to serious complications, including septal perforation, if not promptly treated. The patient's symptoms of nasal pain and swelling, particularly if localized to one side, warrant consideration of this diagnosis.
- Rare diagnoses:
- Nasal tuberculosis: Although rare in many parts of the world, tuberculosis can manifest with chronic nasal symptoms, including pain, swelling, and discharge. The recent history of a GI bug and camping (potential exposure to tuberculosis) makes this a consideration, albeit a rare one.
- Wegener's granulomatosis (Granulomatosis with Polyangiitis): This autoimmune disorder can cause a wide range of symptoms, including nasal pain, swelling, and sinusitis. However, it is rare and typically presents with more systemic symptoms and a longer history of illness.