Differential Diagnosis for 15-year-old Patient with Cough and Congestion
Single Most Likely Diagnosis
- Viral Upper Respiratory Infection (URI): Given the patient's symptoms of cough, congestion, and mild fatigue without fever, chest pain, or shortness of breath, a viral URI is the most likely diagnosis. The patient's recent dental procedure and incomplete adherence to antibiotic treatment may contribute to her current condition, but the absence of severe symptoms suggests a viral etiology.
Other Likely Diagnoses
- Bacterial Pharyngitis: The patient's swollen cervical lymph nodes and recent dental procedure may suggest a bacterial infection, particularly if the patient has not been taking her amoxicillin as prescribed. However, the lack of fever and severe throat pain makes this diagnosis less likely.
- Sinusitis: The patient's congestion and cough, despite trying over-the-counter decongestants, may indicate sinusitis. The recent dental procedure and incomplete antibiotic treatment may have contributed to the development of sinusitis.
- Postnasal Drip: The patient's cough and congestion, in conjunction with her recent dental procedure, may be related to postnasal drip, which can be caused by a viral infection or other factors.
Do Not Miss Diagnoses
- Lemierre's Syndrome: Although rare, Lemierre's syndrome is a potentially life-threatening condition that can occur after a bacterial pharyngitis infection. It is characterized by sepsis, thrombophlebitis, and metastatic infections. The patient's recent dental procedure and incomplete antibiotic treatment increase the risk of this condition.
- Peritonsillar Abscess: The patient's swollen cervical lymph nodes and recent dental procedure may suggest a peritonsillar abscess, which can be a complication of bacterial pharyngitis. Although the patient denies severe throat pain, this condition requires prompt attention.
- Epiglottitis: Although rare in adolescents, epiglottitis is a potentially life-threatening condition that requires immediate attention. The patient's cough and congestion, despite the absence of severe symptoms, warrant consideration of this diagnosis.
Rare Diagnoses
- Tuberculosis (TB): Although unlikely, TB should be considered in the differential diagnosis, particularly if the patient has been exposed to someone with TB or has recently traveled to an area with high TB prevalence.
- Sarcoidosis: This rare condition can cause cough, congestion, and swollen lymph nodes, but it is unlikely in this patient given the absence of other systemic symptoms and the recent dental procedure.
- Angioedema: Although rare, angioedema can cause cough, congestion, and swollen lymph nodes, particularly if the patient has an allergy to a medication, such as amoxicillin. However, the patient denies any known allergies.