Differential Diagnosis for Throat Symptoms

The patient's complaint of a throat getting large and switching sides can be approached by considering various potential causes. Here's a categorized differential diagnosis:

• Single Most Likely Diagnosis

  • Tonsillitis: This condition, often caused by viral or bacterial infections, can lead to swelling of the tonsils, which might be perceived as the throat getting large. The symptoms can sometimes seem to switch sides if the infection affects one tonsil more than the other at different times.

• Other Likely Diagnoses

  • Pharyngitis: Inflammation of the pharynx, which can be due to viral or bacterial causes, might cause the sensation of the throat enlarging. The discomfort can sometimes feel like it's moving from one side to the other.
  • Lymphadenitis: Inflammation of the lymph nodes in the neck, which can be a response to infection, might cause swelling that could be felt as the throat getting large, with the sensation potentially shifting as different nodes become involved.
  • Quinsy (Peritonsillar Abscess): A complication of tonsillitis where an abscess forms beside the tonsils. This could cause severe swelling on one side, potentially feeling like the throat is enlarging and could be perceived as switching sides if the abscess changes size or if the patient experiences referred pain.

• Do Not Miss Diagnoses

  • Epiglottitis: A potentially life-threatening condition that involves inflammation of the epiglottis, which can cause severe swelling and potentially block the airway. Although it might not typically cause symptoms that "switch sides," any condition that could lead to airway obstruction is critical to identify early.
  • Ludwig's Angina: A severe infection of the tissues in the neck, which can cause swelling that might feel like the throat is enlarging. It's a medical emergency due to the risk of airway obstruction.
  • Thyroiditis: Inflammation of the thyroid gland, which can cause swelling in the neck that might be perceived as the throat getting large. Some forms of thyroiditis can lead to serious complications if not properly managed.

• Rare Diagnoses

  • Angioedema: A rare condition characterized by the rapid swelling of the dermis, subcutaneous tissue, mucosa, and submucosal tissues. It can cause the throat to feel like it's swelling and could potentially be life-threatening if the airway is compromised.
  • Sarcoidosis: A disease characterized by abnormal collections of inflammatory cells that can form in any part of the body, including the throat. It could potentially cause swelling that feels like the throat is enlarging, though this would be an uncommon presentation.
  • Tumor (Benign or Malignant): Although rare, a growing tumor in the throat or neck could cause the sensation of the throat getting large. The growth might seem to switch sides depending on its location and the patient's perspective.