Differential Diagnosis for 1 Week Sore Throat
- Single Most Likely Diagnosis
- Viral Pharyngitis: This is the most likely diagnosis given the patient's symptoms of sore throat, chills, headache, fatigue, and congestion, which are common presentations of a viral upper respiratory infection. The lack of fever and negative point-of-care testing for COVID-19, influenza, and strep-A further supports this diagnosis, as viral pharyngitis often does not present with fever and can be caused by a variety of viruses other than those tested for.
- Other Likely Diagnoses
- Acute Bronchitis: The patient's complaint of chest pain when coughing and the burning sensation in the throat could suggest an involvement of the lower respiratory tract, making acute bronchitis a plausible diagnosis. This condition often follows an upper respiratory infection and can present with similar symptoms.
- Allergic Pharyngitis: If the patient is experiencing seasonal allergies or has been exposed to an allergen, allergic pharyngitis could be a consideration, especially with symptoms of congestion.
- Do Not Miss Diagnoses
- Epiglottitis: Although less common and typically presenting with more severe symptoms such as difficulty swallowing and shortness of breath, epiglottitis is a potentially life-threatening condition that requires prompt recognition and treatment. The absence of fever does not rule out this diagnosis.
- Lemierre's Syndrome: This rare but serious condition involves a bacterial infection of the throat that spreads to the jugular vein, leading to thrombophlebitis. It can present with sore throat, fever (though the patient denies fever, it's not always present), and other systemic symptoms.
- Rare Diagnoses
- Infectious Mononucleosis (Mono): Caused by the Epstein-Barr virus, mono can present with sore throat, fatigue, and headache, but typically also includes lymphadenopathy and sometimes fever. It's less likely given the negative strep test and absence of other specific symptoms, but could be considered if other diagnoses are ruled out.
- Tuberculosis (TB): Although very rare and typically presenting with chronic symptoms, TB can cause a sore throat and systemic symptoms like fatigue. It would be an unlikely diagnosis without additional risk factors or symptoms such as weight loss or night sweats.