Differential Diagnosis for Severe Urticaria and Swelling
Single Most Likely Diagnosis
- Allergic Reaction: This is the most likely diagnosis given the symptoms of severe urticaria and swelling after ingesting various substances. The reaction could be anaphylaxis or a severe allergic reaction, which is a life-threatening condition that requires immediate medical attention.
Other Likely Diagnoses
- Anaphylactoid Reaction: Similar to an allergic reaction but does not involve an immune-mediated response. It can be caused by contrast agents used in CT scans or certain medications.
- Drug Hypersensitivity: Given the history of reactions to penicillin, a drug hypersensitivity reaction is possible, especially if the patient has a known allergy to penicillin or similar antibiotics.
- Sulfite Sensitivity: White wine contains sulfites, which can cause allergic reactions in sensitive individuals, leading to symptoms like urticaria and swelling.
Do Not Miss Diagnoses
- Hereditary Angioedema: A rare but potentially life-threatening condition that can cause severe swelling, especially of the face, lips, tongue, or throat. It's crucial to consider this diagnosis, especially if the patient has a family history or if the swelling involves the airway.
- Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis: Although rare, these conditions are severe skin and mucous membrane disorders usually caused by medications, including antibiotics like penicillin. They can present with urticaria and swelling among other symptoms.
Rare Diagnoses
- Mastocytosis: A condition characterized by an accumulation of mast cells in one or more organs, which can lead to episodes of severe allergic reactions, including anaphylaxis.
- Idiopathic Anaphylaxis: A rare condition where anaphylaxis occurs without an identifiable cause, which could potentially be triggered by any of the substances listed if no other explanation is found.