Differential Diagnosis
- Single most likely diagnosis
- Viral pharyngitis: The patient's symptoms of runny nose, cough, sore throat, and intermittent headaches, along with the absence of fever and the presence of a swollen throat with some pus visible on the right tonsil, are consistent with a viral upper respiratory tract infection. The fact that the patient is not acutely unwell and has been experiencing stress also supports this diagnosis, as stress can exacerbate viral infections.
- Other Likely diagnoses
- Bacterial pharyngitis (e.g., streptococcal pharyngitis): Although the patient's symptoms are more suggestive of a viral infection, the presence of pus on the tonsil and a swollen throat could also indicate a bacterial infection. The throat swab will help to confirm or rule out this diagnosis.
- Acute bronchitis: The patient's cough and history of using an inhaler and bronchial syrup suggest that they may have an underlying respiratory condition, and the current symptoms could be an exacerbation of this condition.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Epiglottitis: Although the patient does not have any symptoms of severe respiratory distress or stridor, epiglottitis is a life-threatening condition that requires prompt diagnosis and treatment. The presence of a sore throat and swollen tonsil could be indicative of epiglottitis, especially if the patient's condition worsens.
- Peritonsillar abscess: The patient's swollen throat and pus on the tonsil could be indicative of a peritonsillar abscess, which is a serious condition that requires prompt treatment.
- Rare diagnoses
- Infectious mononucleosis: The patient's symptoms of sore throat, swollen tonsil, and fatigue could be indicative of infectious mononucleosis, although this diagnosis is less likely given the patient's age and lack of other symptoms such as lymphadenopathy or splenomegaly.
- Lemierre's syndrome: This is a rare condition characterized by a bacterial infection of the tonsils and throat, which can lead to serious complications such as sepsis and thrombophlebitis. Although the patient's symptoms are not suggestive of this diagnosis, it is a rare but potentially life-threatening condition that should be considered in the differential diagnosis.