Differential Diagnosis
- Single most likely diagnosis
- Acute tonsillitis: The patient presents with a swollen throat, swollen left tonsil with visible pus, and a history of recent illness treated with antibiotics, which suggests a bacterial infection. The symptoms of nocturnal fevers, sore throat, and productive cough also support this diagnosis.
- Other Likely diagnoses
- Acute bronchitis: The patient's symptoms of productive cough with clear and green phlegm, worse at night, and expiratory crackles at the right lower base suggest a lower respiratory tract infection.
- Acute sinusitis: The patient has a history of previously diagnosed acute sinusitis and presents with symptoms of runny nose, headaches, and facial pain, which could indicate a recurrence or persistence of the condition.
- Asthma exacerbation: The patient has a history of asthma and uses an inhaler when sick, particularly at night when coughing. The symptoms of productive cough and expiratory crackles could also be indicative of an asthma exacerbation.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Epiglottitis: Although the patient does not have the classic symptoms of epiglottitis, such as severe dysphagia or stridor, it is essential to consider this diagnosis due to the potential for airway obstruction and rapid deterioration.
- Pneumonia: The patient's symptoms of productive cough, fevers, and expiratory crackles could also be indicative of pneumonia, which can be a life-threatening condition if not promptly treated.
- Quinsy (peritonsillar abscess): The patient's swollen tonsil with visible pus could be a sign of a peritonsillar abscess, which requires prompt drainage to prevent complications.
- Rare diagnoses
- Lemierre's syndrome: This rare condition is characterized by a bacterial infection of the tonsils and throat, which can lead to sepsis and other complications. Although the patient's symptoms do not strongly suggest this diagnosis, it is essential to consider it due to its potential severity.
- Tuberculosis: The patient's symptoms of chronic cough, fevers, and night sweats could be indicative of tuberculosis, although this diagnosis is less likely given the patient's lack of exposure history and negative social history.