Differential Diagnosis for 57-year-old Female with Sinus Pressure and Associated Symptoms

• Single most likely diagnosis:
  • Acute Sinusitis: This is the most likely diagnosis given the patient's symptoms of sinus pressure, headache, nasal congestion, rhinorrhea, and cough, which are all consistent with an infection of the sinuses. The addition of left ear pain could indicate Eustachian tube dysfunction, a common complication of sinusitis.
• Other Likely diagnoses:
  • Upper Respiratory Tract Infection (URTI): The patient's symptoms of cough, wheezing, and rhinorrhea could also be indicative of a viral URTI, which often presents with similar symptoms to sinusitis.
  • Allergic Rhinitis: The symptoms of nasal congestion, rhinorrhea, and cough could be due to an allergic reaction, especially if the patient has a history of allergies.
  • Acute Otitis Media: The left ear pain and intermittent dizziness could suggest an infection of the middle ear, which is a possible complication of Eustachian tube dysfunction.
• Do Not Miss (ddxs that may not be likely, but would be deadly if missed.):
  • Meningitis: Although less likely, the combination of headache, neck soreness, and dizziness could be indicative of meningitis, a potentially life-threatening infection of the meninges.
  • Temporal Arteritis: This condition, also known as giant cell arteritis, can present with headache, jaw claudication, and visual disturbances, but may also cause nonspecific symptoms such as neck soreness and dizziness.
  • Brain Abscess: A rare but potentially deadly complication of sinusitis, brain abscess could present with similar symptoms, including headache, dizziness, and neck soreness.
• Rare diagnoses:
  • Wegener's Granulomatosis: A rare autoimmune disorder that can cause sinusitis, otitis, and other respiratory symptoms, but is much less likely given the patient's presentation.
  • Sarcoidosis: A systemic granulomatous disease that can cause sinusitis, cough, and other respiratory symptoms, but is relatively rare and would require further evaluation to diagnose.