Differential Diagnosis for 18-year-old Female with Recurring Sore Throat Symptoms
- Single Most Likely Diagnosis
- Chronic rhinosinusitis: This condition is characterized by persistent inflammation of the nasal and sinus passages, often leading to symptoms such as nasal congestion, postnasal drainage, and sore throat. The patient's history of recurring sore throat symptoms, despite negative strep tests and treatment with antibiotics and steroids, along with associated symptoms of intermittent nasal congestion and postnasal drainage, makes this diagnosis a strong consideration.
- Other Likely Diagnoses
- Allergic rhinitis: The patient's symptoms of nasal congestion, postnasal drainage, and sore throat could be indicative of allergic rhinitis, especially if she has a history of allergies or exposure to allergens.
- Tonsillitis (viral or bacterial): Although the patient has had negative strep tests, it's possible that she has a viral tonsillitis or a bacterial infection not caused by streptococcus.
- Laryngopharyngeal reflux (LPR): LPR can cause symptoms such as sore throat, nasal congestion, and postnasal drainage, and may be considered if the patient has a history of gastroesophageal reflux disease (GERD) or other risk factors.
- Do Not Miss Diagnoses
- Epiglottitis: Although rare, epiglottitis is a life-threatening condition that requires prompt recognition and treatment. The patient's symptoms of sore throat and swelling could be indicative of epiglottitis, especially if she has a high fever, difficulty swallowing, or shortness of breath.
- Peritonsillar abscess: This is a serious complication of tonsillitis that can cause severe sore throat, swelling, and difficulty swallowing. Although the patient has had negative strep tests, a peritonsillar abscess is still possible and requires urgent evaluation.
- Malignancy (e.g., lymphoma, nasopharyngeal carcinoma): Although rare, malignancies can cause persistent sore throat symptoms, nasal congestion, and postnasal drainage. A thorough evaluation, including imaging studies and biopsy, may be necessary to rule out these conditions.
- Rare Diagnoses
- Granulomatosis with polyangiitis (GPA): This is a rare autoimmune disorder that can cause symptoms such as sore throat, nasal congestion, and postnasal drainage, as well as other systemic symptoms.
- Sarcoidosis: This is a rare condition that can cause inflammation in various parts of the body, including the lungs, skin, and eyes, and can also cause symptoms such as sore throat and nasal congestion.
- Infectious mononucleosis: Although the patient has had negative strep tests, infectious mononucleosis (caused by Epstein-Barr virus) can cause persistent sore throat symptoms, as well as other systemic symptoms such as fever and fatigue.