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Last updated: October 25, 2025View editorial policy

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Upper Respiratory Tract Infection Differential Diagnosis

Single Most Likely Diagnosis

  • Viral Pharyngitis: This is the most common cause of upper respiratory tract infections, often resulting from viruses such as rhinovirus, coronavirus, adenovirus, and respiratory syncytial virus. Symptoms include sore throat, runny nose, cough, and fever, which are typical for a viral infection.

Other Likely Diagnoses

  • Bacterial Pharyngitis (Streptococcal): Caused by Group A beta-hemolytic streptococcus, this condition presents with severe sore throat, fever, and swollen lymph nodes. It's less common than viral pharyngitis but important to diagnose due to the need for antibiotic treatment.
  • Influenza: Characterized by sudden onset of high fever, chills, sore throat, runny or stuffy nose, cough, and muscle or body aches. Influenza is a significant cause of morbidity, especially in certain high-risk populations.
  • Acute Sinusitis: Often follows a viral upper respiratory infection, leading to inflammation of the sinuses. Symptoms include facial pain, nasal congestion, and purulent nasal discharge.

Do Not Miss Diagnoses

  • Epiglottitis: A potentially life-threatening condition that requires immediate medical attention. It involves inflammation of the epiglottis, which can lead to airway obstruction. Symptoms include severe sore throat, difficulty swallowing, and shortness of breath.
  • Lemierre's Syndrome: A rare but serious condition following a bacterial pharyngitis, typically caused by Fusobacterium necrophorum. It leads to septic thrombophlebitis of the internal jugular vein and can present with neck pain, swelling, and fever.
  • Retropharyngeal Abscess: An infection in the tissues in the back of the throat, which can cause severe throat pain, difficulty swallowing, and shortness of breath. It's a medical emergency due to the risk of airway compromise.

Rare Diagnoses

  • Diphtheria: A bacterial infection affecting the membranes of the throat and nose. Though rare in areas with widespread vaccination, it can still occur, especially in unvaccinated individuals. Symptoms include a thick, grey membrane covering the tonsils and throat.
  • Mononucleosis (Infectious): Caused by the Epstein-Barr virus, this condition is characterized by fever, sore throat, swollen lymph nodes, and fatigue. It's more common in adolescents and young adults.
  • Tuberculosis (TB): A bacterial infection that can affect the lungs and other parts of the body. While not typically considered an upper respiratory tract infection, TB can present with chronic cough, fever, and weight loss, and is crucial to diagnose due to its public health implications and the need for specific treatment.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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