Differential Diagnosis for Rhinosinusitis with Painful Left Side Superior Maxillary and Left Periorbital Pain
- Single Most Likely Diagnosis
- Acute bacterial sinusitis: This is the most likely diagnosis given the symptoms of rhinosinusitis, painful left side superior maxillary, and left periorbital pain, especially with recent travel which may have exposed the patient to new pathogens or changed environmental pressures.
- Other Likely Diagnoses
- Dental infection or abscess: Pain when masticating on the left side could indicate a dental issue, such as an infection or abscess, which could also cause referred pain to the maxillary and periorbital areas.
- Viral rhinosinusitis: Although less severe than bacterial sinusitis, viral infections can still cause significant discomfort and pain, especially if the patient has recently traveled and been exposed to new viruses.
- Allergic rhinitis: If the patient has allergies, recent travel could have exposed them to new allergens, leading to allergic rhinitis, which can cause sinus pressure and pain.
- Do Not Miss Diagnoses
- Cavernous sinus thrombosis: A rare but potentially life-threatening complication of sinusitis, characterized by the formation of a blood clot in the cavernous sinus, which can lead to severe headache, facial pain, and potentially blindness or stroke.
- Orbital cellulitis: An infection of the tissues surrounding the eye, which can cause pain, swelling, and redness around the eye, and can lead to serious complications if not treated promptly.
- Malignancy (e.g., sinus or nasal cavity cancer): Although rare, cancer in the sinuses or nasal cavity can cause persistent pain, sinus pressure, and other symptoms similar to those of rhinosinusitis.
- Rare Diagnoses
- Wegener's granulomatosis (Granulomatosis with Polyangiitis): A rare autoimmune disorder that can cause inflammation of the blood vessels, including those in the sinuses, leading to symptoms similar to rhinosinusitis.
- Fungal sinusitis: More common in immunocompromised patients, fungal infections of the sinuses can cause chronic pain, sinus pressure, and other symptoms.
- Temporomandibular joint (TMJ) disorder: Although primarily associated with jaw pain, TMJ disorders can sometimes cause referred pain to the face and sinuses, potentially mimicking some symptoms of rhinosinusitis.