Differential Diagnosis for Rhinosinusitis with Painful Left Side Superior Maxillary and Left Periorbital Pain
Single Most Likely Diagnosis
- Viral or Bacterial Rhinosinusitis: The symptoms of painful left side superior maxillary and left periorbital pain, especially when exacerbated by mastication, are classic for rhinosinusitis, which involves inflammation of the paranasal sinuses. Recent travel could expose the individual to new pathogens, increasing the likelihood of infection.
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 refer pain to the maxillary and periorbital areas.
- Temporomandibular Joint (TMJ) Disorder: TMJ disorders can cause pain in the jaw and face, including the maxillary area, and can be exacerbated by chewing.
- Tension Headache: While less likely to cause localized pain with mastication, tension headaches can cause facial pain and are exacerbated by stress, which could be related to recent travel.
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. Symptoms can include periorbital pain, but it requires immediate medical attention.
- Orbital Cellulitis: An infection of the tissues surrounding the eye, which can cause periorbital pain and swelling. It is a medical emergency due to the risk of vision loss and intracranial complications.
- Meningitis: Although less directly related to the symptoms, meningitis is an infection of the protective membranes covering the brain and spinal cord and can present with headache and facial pain. It is a medical emergency.
Rare Diagnoses
- Barosinusitis: While it could be considered, especially with recent travel involving air pressure changes (e.g., flying), barosinusitis (sinus barotrauma) is less likely without specific symptoms related to pressure changes, such as pain during descent.
- Trigeminal Neuralgia: A chronic pain condition that affects the trigeminal nerve, which could cause facial pain, including in the maxillary area. However, it typically presents with more characteristic lightning-like pains rather than constant pain exacerbated by mastication.
- Sinus Tumors: Although very rare, tumors in the sinuses could cause localized pain and should be considered in the differential diagnosis, especially if symptoms persist or worsen over time despite appropriate treatment for more common conditions.