Differential Diagnosis for Recurrent Upper Respiratory Infections
- The following differential diagnosis is organized into categories to guide the thought process and identify the most likely causes of recurrent upper respiratory infections, sinusitis, strep throat, and tonsillitis over a 4-year period.
Single Most Likely Diagnosis
- Allergic Rhinitis: This condition is a common cause of recurrent upper respiratory infections, as it can lead to chronic inflammation and increased susceptibility to infections. Allergies can cause sinusitis, and the resulting congestion can increase the risk of strep throat and tonsillitis.
- Viral Upper Respiratory Infections: Viral infections, such as the common cold, are a common cause of recurrent upper respiratory infections, and they can lead to secondary bacterial infections like strep throat and tonsillitis.
Other Likely Diagnoses
- Immunoglobulin A (IgA) Deficiency: This is a common primary immunodeficiency that can increase the risk of recurrent infections, particularly sinusitis and upper respiratory infections.
- Anatomical Abnormalities: Conditions like a deviated septum, nasal polyps, or enlarged tonsils can increase the risk of recurrent infections by obstructing normal drainage and airflow.
- Gastroesophageal Reflux Disease (GERDES): GERD can cause reflux of stomach acid into the upper respiratory tract, leading to chronic inflammation and increased susceptibility to infections.
Do Not Miss Diagnoses
- HIV Infection: Although less common, HIV infection can cause recurrent upper respiratory infections due to immunosuppression. It is essential to consider this diagnosis to avoid missing a potentially life-threatening condition.
- Primary Immunodeficiency Diseases: Conditions like Common Variable Immunodeficiency (CVID) or Selective IgA Deficiency can increase the risk of recurrent infections and require prompt diagnosis and treatment.
- Cystic Fibrosis: This genetic disorder can cause recurrent respiratory infections, including sinusitis and upper respiratory infections, due to abnormal mucus production and impaired clearance.
Rare Diagnoses
- Chronic Granulomatous Disease (CGD): This rare primary immunodeficiency can increase the risk of recurrent infections, particularly those caused by catalase-positive bacteria.
- Hyper-IgE Syndrome: This rare condition is characterized by elevated IgE levels and can cause recurrent skin and respiratory infections.
- Wiskott-Aldrich Syndrome: This rare X-linked recessive disorder can cause recurrent infections, including upper respiratory infections, due to immunodeficiency and thrombocytopenia.