Differential Diagnosis for Rhinosinusitis, Laryngotracheobronchitis, Cervical Lymphadenitis, and Parotitis in Human Adults
- Single Most Likely Diagnosis
- Influenza virus: This is a common cause of respiratory illnesses, including rhinosinusitis and laryngotracheobronchitis, and can also lead to complications such as cervical lymphadenitis. While parotitis is less common, influenza can cause a wide range of symptoms.
- Other Likely Diagnoses
- Respiratory Syncytial Virus (RSV): Although more commonly associated with lower respiratory tract infections in children, RSV can cause upper respiratory symptoms in adults, including rhinosinusitis and laryngotracheobronchitis.
- Adenovirus: Known to cause a variety of respiratory illnesses, including the common cold, bronchitis, and pneumonia, adenovirus can also lead to cervical lymphadenitis and, in some cases, parotitis.
- Parainfluenza virus: This virus is a common cause of respiratory infections, particularly laryngotracheobronchitis (croup) in children, but can also affect adults, causing similar symptoms.
- Human Metapneumovirus: Similar to RSV, this virus can cause respiratory tract infections, including rhinosinusitis and laryngotracheobronchitis, in adults.
- Do Not Miss Diagnoses
- Mumps virus: Although vaccination has made mumps less common, it is a critical diagnosis not to miss due to the potential for serious complications, including orchitis, meningitis, and permanent hearing loss. Mumps classically causes parotitis, and while less common, can also lead to the other mentioned symptoms.
- HIV: Primary HIV infection can present with a variety of nonspecific symptoms, including fever, lymphadenopathy (which could include cervical lymphadenitis), and upper respiratory symptoms. Missing this diagnosis could have significant long-term consequences.
- Rare Diagnoses
- Coxsackievirus: Part of the enterovirus family, coxsackievirus can cause a range of diseases, including hand, foot, and mouth disease, and can occasionally lead to more severe manifestations like parotitis and respiratory symptoms.
- Echovirus: Another member of the enterovirus family, echovirus can cause similar symptoms to coxsackievirus, including respiratory illnesses and, less commonly, parotitis.
- Lymphocytic choriomeningitis virus (LCMV): Although more commonly associated with neurological symptoms, LCMV can cause a prodrome that includes upper respiratory symptoms and lymphadenopathy. It's a rare but potentially serious infection, especially in immunocompromised individuals.