Differential Diagnosis
- Single most likely diagnosis
- Acute Sinusitis: The patient's symptoms of sinus pressure, headache, and fullness in the ears, combined with a cough due to postnasal drip, are classic for acute sinusitis. The fact that seasonal allergy medications do not alleviate symptoms suggests that the cause may be infectious rather than allergic.
- Other Likely diagnoses
- Viral Upper Respiratory Infection (URI): The symptoms could also be consistent with a viral URI, which often presents with similar symptoms including cough, headache, and nasal congestion.
- Allergic Rhinitis: Although the patient's seasonal allergy medications do not change symptoms, it's possible that the medications are not effective or that the patient has developed new allergies.
- Eustachian Tube Dysfunction: This condition can cause fullness in the ears and is often associated with nasal congestion and sinus pressure.
- Do Not Miss diagnoses
- Bacterial Sinusitis with Complications (e.g., orbital cellulitis, cavernous sinus thrombosis): Although less likely, it's crucial to consider the possibility of bacterial sinusitis, especially if symptoms worsen or do not improve with treatment, as complications can be severe and life-threatening.
- Mastoiditis: This is an infection of the mastoid bone in the skull, which can cause symptoms similar to those described, including ear fullness and headache.
- Rare diagnoses
- Sarcoidosis: A systemic disease that can cause sinusitis and other respiratory symptoms, although it would be an unusual presentation.
- Wegener's Granulomatosis (Granulomatosis with Polyangiitis): A rare autoimmune disorder that can cause sinusitis, although other systemic symptoms would typically be present.
- Tumors (e.g., nasopharyngeal carcinoma): Although extremely rare, tumors in the nasal cavity or sinuses can cause similar symptoms and should be considered if symptoms persist or worsen despite treatment.