Differential Diagnosis for Nasal Congestion and Sinus Pressure

Given the symptoms of nasal congestion and sinus pressure for 8 days, the following differential diagnoses can be considered:

• Single Most Likely Diagnosis
  • Viral Upper Respiratory Infection (URTI): This is the most common cause of nasal congestion and sinus pressure, often presenting with additional symptoms such as cough, sore throat, and fatigue. The duration of 8 days is consistent with the typical course of a viral URTI.
• Other Likely Diagnoses
  • Acute Bacterial Sinusitis: This condition can present with similar symptoms to viral URTI but is more likely to be considered if symptoms worsen over time or if there are signs of bacterial infection such as purulent nasal discharge or facial pain.
  • Allergic Rhinitis: If the patient has a history of allergies, allergic rhinitis could be a likely cause, especially if symptoms are seasonal or triggered by specific allergens.
• Do Not Miss Diagnoses
  • Invasive Fungal Sinusitis: Although rare, this condition can be life-threatening, especially in immunocompromised patients. It requires prompt diagnosis and treatment.
  • Orbital Cellulitis: An infection that can spread from the sinuses to the orbit, causing severe complications if not promptly treated.
  • Cavernous Sinus Thrombosis: A rare but potentially fatal condition that can arise from facial or sinus infections, characterized by thrombosis of the cavernous sinus.
• Rare Diagnoses
  • Wegener's Granulomatosis (Granulomatosis with Polyangiitis): A rare autoimmune disorder that can cause sinusitis among other systemic symptoms.
  • Sarcoidosis: A condition that can affect multiple parts of the body, including the sinuses, though sinus involvement is less common.
  • Tumors (e.g., nasopharyngeal carcinoma): Although extremely rare as a cause of these symptoms, tumors can cause nasal congestion and sinus pressure, especially if they obstruct the nasal passages or sinuses.

Each of these diagnoses has a different set of implications for treatment and patient outcomes, emphasizing the importance of a thorough diagnostic evaluation.