Differential Diagnosis for New Onset Hoarse Voice with Sore Throat and Feverishness

• Single Most Likely Diagnosis
  • Acute Laryngitis: This is the most common cause of a hoarse voice, often resulting from a viral upper respiratory infection that leads to inflammation of the larynx. The presence of sore throat and feverishness supports this diagnosis, as these symptoms frequently accompany viral infections.
• Other Likely Diagnoses
  • Pharyngitis: Caused by viral or bacterial infections, pharyngitis can lead to sore throat and fever. While it primarily affects the pharynx, inflammation can extend to the larynx, causing hoarseness.
  • Laryngopharyngeal Reflux (LPR): Stomach acid reflux into the throat can cause irritation and inflammation of the larynx, leading to hoarseness and sore throat. Feverishness might not be a direct symptom but could be present if there's an associated infection.
  • Sinusitis: Inflammation of the sinuses can lead to postnasal drip, which may irritate the throat and larynx, causing hoarseness and sore throat. Fever can be present, especially if the sinusitis is caused by a bacterial infection.
• Do Not Miss Diagnoses
  • Epiglottitis: Although rare, epiglottitis is a potentially life-threatening condition that requires immediate medical attention. It can cause severe sore throat, difficulty swallowing, hoarseness, and fever. The risk of airway obstruction makes it a critical diagnosis not to miss.
  • Peritonsillar Abscess: This is a serious complication of tonsillitis where an abscess forms beside the tonsils. It can cause severe sore throat, fever, and changes in voice due to the swelling and pain. While less directly linked to hoarseness, the severity of the condition warrants its inclusion in this category.
  • Laryngeal Cancer: Though rare and less likely in the absence of other risk factors (like smoking), laryngeal cancer can present with hoarseness. It's essential to consider this diagnosis, especially in patients with risk factors or if symptoms persist beyond what's expected for a viral infection.
• Rare Diagnoses
  • Diphtheria: A bacterial infection that can cause a membrane to form in the throat, leading to hoarseness, sore throat, and fever. It's rare in areas with high vaccination rates but should be considered in unvaccinated individuals or those traveling from areas where diphtheria is more common.
  • Tuberculosis (TB) Laryngitis: TB can affect the larynx, causing hoarseness, sore throat, and systemic symptoms like fever. This diagnosis is more likely in individuals with known TB exposure or those with compromised immune systems.
  • Sarcoidosis: A condition that can cause inflammation in various parts of the body, including the larynx, leading to hoarseness. It might also cause fever and other systemic symptoms, though it's a less common cause of these specific symptoms.