Differential Diagnosis for a 34-year-old Man with Left Nasal Passage Feeling Blocked
Single Most Likely Diagnosis
- Allergic Rhinitis: This is the most likely diagnosis given the symptoms of nasal blockage and red nasal passages without any visible mucus or septal deviation. Allergic rhinitis can cause chronic or intermittent nasal congestion, sneezing, and runny nose, which aligns with the patient's symptoms of continuous snuggling (likely a typo for sniffling).
Other Likely Diagnoses
- Vasomotor Rhinitis: This condition is characterized by chronic nasal congestion and rhinorrhea (runny nose) without an identifiable allergen. It could be a consideration if the patient's symptoms persist without a clear allergic cause.
- Anatomical Obstruction: Although the examination did not reveal septal deviation, other anatomical issues like nasal polyps or turbinate bone hypertrophy could cause unilateral nasal obstruction and should be considered.
- Infectious Rhinitis: Although no mucus is noted, a viral or bacterial infection could still be present, especially if the patient has recently been exposed to someone with a similar illness.
Do Not Miss Diagnoses
- Nasal Tumor: Although rare, a tumor in the nasal passage could cause unilateral obstruction. It's crucial to rule out this possibility, especially if the patient's symptoms are persistent and unresponsive to initial treatments.
- Granulomatosis with Polyangiitis (GPA): Formerly known as Wegener's granulomatosis, GPA is a rare autoimmune disorder that can affect the nasal passages and sinuses, causing destruction and obstruction. It's a critical diagnosis not to miss due to its potential for severe complications.
Rare Diagnoses
- Sarcoidosis: This autoimmune disease can affect multiple parts of the body, including the nasal passages, causing granulomatous inflammation and potential obstruction.
- Foreign Body: Although more common in children, it's possible for adults to have a foreign body lodged in their nasal passage, causing obstruction. This would be an unusual cause in an adult but should be considered if the history suggests a possibility of insertion.