Differential Diagnosis
- The patient presents with a complex set of symptoms, including sore throat, cough, sneezing, and bilateral eye redness with thick drainage. The following differential diagnosis is organized into categories:
Single Most Likely Diagnosis
- Viral Conjunctivitis: This diagnosis is likely due to the patient's symptoms of bilateral eye redness, thick drainage, and crusting, which are characteristic of viral conjunctivitis. The fact that the symptoms started in one eye and then moved to the other eye also supports this diagnosis.
Other Likely Diagnoses
- Allergic Conjunctivitis: The patient's significant past medical history of allergic rhinitis and the presence of sneezing and cough suggest that allergic conjunctivitis is a possible diagnosis. However, the thick drainage and crusting are more characteristic of viral conjunctivitis.
- Viral Pharyngitis: The patient's symptoms of sore throat and cough, which started 7 days ago, could be indicative of viral pharyngitis. The fact that the rapid strep test was negative also supports this diagnosis.
Do Not Miss Diagnoses
- Gonococcal Conjunctivitis: Although less likely, gonococcal conjunctivitis is a serious diagnosis that must be considered, especially in adults. The patient's symptoms of thick drainage and crusting could be indicative of this diagnosis.
- Herpes Simplex Keratitis: This diagnosis is also important to consider, as it can cause serious complications if left untreated. The patient's symptoms of eye redness and thick drainage could be indicative of herpes simplex keratitis.
Rare Diagnoses
- Chlamydial Conjunctivitis: This diagnosis is less likely, but it is still important to consider, especially in adults. The patient's symptoms of eye redness and thick drainage could be indicative of chlamydial conjunctivitis.
- Kawasaki Disease: Although rare, Kawasaki disease is an important diagnosis to consider in adults, as it can cause serious complications if left untreated. The patient's symptoms of bilateral eye redness and thick drainage could be indicative of Kawasaki disease.