Differential Diagnosis for Nasal Obstruction and Facial Pain
- Single most likely diagnosis
- D. Subacute rhinosinusitis: This diagnosis is the most likely because the patient's symptoms have persisted for 6 weeks, which falls within the 4-12 week timeframe that defines subacute rhinosinusitis. The symptoms of nasal obstruction, non-purulent nasal discharge, and maxillary facial pain are also consistent with this condition.
- Other Likely diagnoses
- B. Chronic rhinosinusitis: Although the patient's symptoms have not lasted long enough to meet the 12-week duration typically required for a diagnosis of chronic rhinosinusitis, it is still a consideration given the nature of her symptoms. Chronic rhinosinusitis could be a potential diagnosis if the symptoms persist beyond 12 weeks.
- A. Acute rhinosinusitis: This could be considered if the patient's symptoms were to suddenly worsen or if there were signs of an acute infection, but given the duration and stability of her symptoms, it is less likely.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Nasal or sinus tumors: Although rare, tumors in the nasal or sinus cavities could present with similar symptoms and would have significant implications for treatment and prognosis if missed.
- Invasive fungal sinusitis: This is a rare but potentially life-threatening condition, especially in immunocompromised patients. It requires prompt diagnosis and treatment.
- Rare diagnoses
- Wegener's granulomatosis (Granulomatosis with Polyangiitis): A rare autoimmune disorder that can affect the sinuses and present with similar symptoms, but would typically include other systemic symptoms.
- Allergic fungal sinusitis: A condition that occurs in allergic individuals and can cause chronic sinusitis symptoms, but is less common and would typically be associated with a history of allergies and specific findings on imaging or histology.