Differential Diagnosis for 72-year-old Female with Various Symptoms
Single Most Likely Diagnosis
- Allergic Rhinitis: The patient's symptoms of nasal congestion, sinus pressure, postnasal drip, itchy or watery eyes, and non-productive cough are classic for allergic rhinitis. The absence of fever and body aches also supports this diagnosis, as allergic rhinitis is typically not associated with systemic symptoms like fever.
Other Likely Diagnoses
- Sinusitis: Given the symptoms of nasal congestion, sinus pressure, and postnasal drip, sinusitis is a plausible diagnosis. The presence of dental pain and ear pain could be referred pain from the sinuses.
- Upper Respiratory Tract Infection (URTI): Although the patient denies fever and chest congestion, a URTI could still be considered, especially with symptoms like cough, headache, and fatigue.
- Temporomandibular Joint (TMJ) Disorder: The patient's complaint of ear pain and dental pain could be related to a TMJ disorder, which can also cause referred pain to the face and head.
Do Not Miss Diagnoses
- Angioedema: Although less likely, angioedema could present with similar symptoms like itchy or watery eyes and could be life-threatening if not recognized and treated promptly.
- Giant Cell Arteritis: This condition can cause headache, jaw claudication, and visual disturbances, but the patient denies changes in vision. However, it's crucial to consider this diagnosis due to its potential for serious complications like blindness.
- Malignancy (e.g., Sinus or Nasopharyngeal Cancer): Although rare, malignancies in the sinuses or nasopharynx could present with similar symptoms and would be catastrophic if missed.
Rare Diagnoses
- Sjögren's Syndrome: This autoimmune disorder can cause dry eyes and mouth, but the patient denies dry eyes. However, it could still be considered, especially if the patient has other systemic symptoms.
- Trigeminal Neuralgia: This condition can cause severe facial pain, but the patient denies facial pain. It's still worth considering due to its distinct presentation and the need for specific treatment.