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 with recent travel, are highly suggestive of rhinosinusitis. The pain when masticating food on the left side further supports this diagnosis, as it indicates involvement of the maxillary sinus.
Other Likely Diagnoses
- Dental Infection or Abscess: Given the pain when masticating food on the left side, a dental infection or abscess should be considered, as it can refer pain to the maxillary and periorbital areas.
- Barosinusitis: Although the severe pain began a few days after the flight, barosinusitis is a possibility, especially if there was ear pressure during descent. Barosinusitis can occur due to pressure changes during air travel, affecting the sinuses.
- Tension Headache or Migraine: These conditions can cause periorbital pain and might be exacerbated by travel or other factors. However, the specific localization of pain to the left side and the association with mastication make them less likely.
Do Not Miss Diagnoses
- Cavernous Sinus Thrombosis: Although rare, this condition is potentially life-threatening and can present with periorbital pain, especially if there's an underlying infection like sinusitis. It requires immediate medical attention.
- Orbital Cellulitis: An infection of the tissues surrounding the eye, which can be a complication of sinusitis. It's critical to diagnose and treat promptly to avoid serious complications.
- Temporal Arteritis: This condition, more common in older adults, can cause headache and facial pain, including pain in the jaw when chewing (jaw claudication). It's essential to consider due to the risk of vision loss if not treated.
Rare Diagnoses
- Sphenoid Sinusitis: Although less common than maxillary or frontal sinusitis, sphenoid sinusitis can cause deep facial or retro-orbital pain and should be considered, especially if other diagnoses are ruled out.
- Trigeminal Neuralgia: A condition characterized by intense pain in the face, typically triggered by light touch or chewing. It's less likely given the context of recent travel and the specific pattern of pain, but it remains a rare possibility.
- Osteomyelitis of the Maxilla: A rare infection of the bone that could cause pain in the maxillary area, especially if there's a history of trauma or infection. It would be an unusual presentation without other systemic signs of infection.