Differential Diagnosis for 30-year-old Female with Respiratory Symptoms
- Single most likely diagnosis
- Acute Bacterial Sinusitis: The patient's symptoms of thick green nasal drainage, sinus pressure, and persistence of symptoms despite over-the-counter medications suggest a bacterial infection of the sinuses. The initial resolution of symptoms followed by recurrence after her son became sick could indicate a secondary bacterial infection following a viral upper respiratory infection.
- Other Likely diagnoses
- Viral Upper Respiratory Infection (URI): Although the patient's symptoms initially resolved, the recurrence could be due to a new viral infection, especially given her recent exposure to her sick son.
- Allergic Rhinitis: The patient's history of seasonal allergies and symptoms of nasal congestion, postnasal drainage, and sinus pressure could be exacerbated by allergens, contributing to her current condition.
- Chronic Sinusitis: If the patient has a history of recurrent sinus infections or persistent symptoms, chronic sinusitis could be a consideration, especially with her history of smoking which can impair sinus drainage.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Invasive Fungal Sinusitis: Although rare, this condition can be life-threatening, especially in immunocompromised individuals. The patient's symptoms of sinus pressure and thick nasal drainage could be indicative of this condition, and a high index of suspicion is necessary.
- Tuberculosis (TB): TB can present with chronic cough, sinusitis, and other respiratory symptoms. Given the patient's history of smoking and potential exposure to others with respiratory infections, TB should be considered, although it is less likely.
- Lemierre's Syndrome: This rare condition involves a bacterial infection of the throat that spreads to the sinuses and can cause severe complications, including sepsis and thrombophlebitis.
- Rare diagnoses
- Wegener's Granulomatosis (Granulomatosis with Polyangiitis): This autoimmune disorder can cause sinusitis, among other symptoms, and should be considered in patients with recurrent or severe sinus infections.
- Sarcoidosis: This condition can cause sinusitis and other respiratory symptoms, although it is relatively rare and would require further evaluation to diagnose.
- Cystic Fibrosis: Although typically diagnosed in childhood, cystic fibrosis can present in adulthood with recurrent sinus infections and respiratory symptoms.