Differential Diagnosis for Ear, Throat, and Nose Symptoms

Single Most Likely Diagnosis

• Viral Upper Respiratory Tract Infection (URTI): The patient's symptoms of a runny nose, ear, and throat discomfort, particularly affecting one side initially and then progressing, are classic for a viral URTI. The onset of symptoms on Friday and progression to include nasal symptoms today fits a typical viral infection timeline.

Other Likely Diagnoses

• Allergic Rhinitis: Although the patient's symptoms started with ear and throat discomfort, the recent onset of a runny nose could suggest allergic rhinitis, especially if the patient has a history of allergies.
• Sinusitis: Given the nasal symptoms that started today, sinusitis is a possibility, especially if the patient's symptoms worsen or include facial pain, headache, or fever.
• Otitis Media or External Otitis: The ear discomfort could be indicative of otitis media (middle ear infection) or otitis externa (swimmer's ear), especially if the patient has recently been swimming or has a history of ear infections.

Do Not Miss Diagnoses

• Lemierre's Syndrome: Although rare, this condition involves a bacterial infection of the throat that can lead to serious complications, including jugular vein thrombosis. It's crucial to consider in patients with severe or persistent throat symptoms.
• Peritonsillar Abscess: A collection of pus behind the tonsils that can cause severe throat pain, difficulty swallowing, and fever. It requires prompt medical attention.
• Mastoiditis: An infection of the mastoid bone in the skull, which can be a complication of otitis media. It's a medical emergency if suspected.

Rare Diagnoses

• Tuberculosis (TB): Although rare in many parts of the world, TB can present with chronic symptoms affecting the lungs, but also potentially the ears, throat, and nose.
• Sarcoidosis: A condition that can affect multiple parts of the body, including the lungs, skin, and eyes, but can also cause symptoms in the ears, throat, and nose.
• Wegener's Granulomatosis (Granulomatosis with Polyangiitis): A rare autoimmune disorder that can affect various parts of the body, including the respiratory tract, and present with a wide range of symptoms.

The patient's request for a refill of ropinirole, which is used to treat Parkinson's disease and restless legs syndrome, does not directly relate to the current symptoms but should be addressed as part of the patient's ongoing care.