What is the likely diagnosis for a post-prostatectomy patient with persistent symptoms of intermittent fever, fatigue, hypertension, sleep disturbances, and pedal edema, with laboratory results showing anemia, thrombocytopenia, and elevated procalcitonin?

Differential Diagnosis for the Patient's Condition

The patient's symptoms and lab results suggest a complex condition with multiple possible causes. Here's a categorized differential diagnosis:

• Single Most Likely Diagnosis
  • Chronic sinusitis or persistent bacterial infection: The patient's history of sinusitis, recent endonasal maxillary antrotomy, and moderate growth of Staphylococcus epidermidis on the nasal swab suggest a lingering sinus infection. The elevated procalcitonin and ESR levels also support this diagnosis.
• Other Likely Diagnoses
  • Post-operative infection or complication: The patient's recent surgery and ongoing symptoms of fever, tiredness, and high blood pressure could be related to a post-operative infection or complication.
  • Anemia of chronic disease: The patient's lab results show anemia, thrombocytopenia, and elevated ESR, which could be indicative of anemia of chronic disease.
  • Hypertension: The patient's high blood pressure could be a contributing factor to their symptoms, particularly the swelling feet.
• Do Not Miss Diagnoses
  • Endocarditis: Although the patient's procalcitonin level is not severely elevated, the presence of Staphylococcus epidermidis on the nasal swab and the patient's history of recent surgery increase the risk of endocarditis.
  • Sepsis: The patient's fever, tiredness, and elevated ESR and procalcitonin levels could be indicative of sepsis, particularly if the infection is not adequately controlled.
  • Prostate cancer recurrence: Although the patient's PSA level is 0, it is essential to consider the possibility of prostate cancer recurrence, particularly given the patient's history of prostate cancer.
• Rare Diagnoses
  • IgG4-related disease: Although the patient's IgG4 levels are normal, it is essential to consider this diagnosis, particularly given the patient's history of sinusitis and recent surgery.
  • Autoimmune disorder: Although the patient's autoimmune markers are negative, it is essential to consider the possibility of an autoimmune disorder, particularly given the patient's symptoms of fever, tiredness, and high blood pressure.
  • Lymphoma: The patient's anemia, thrombocytopenia, and elevated ESR could be indicative of lymphoma, although this is a rare diagnosis.