What is the cause of a 35-year-old female's sore throat, cough, sneezing, and conjunctivitis with thick drainage, after recent streptococcal pharyngitis treatment with amoxicillin and a history of allergic rhinitis, with a negative rapid strep test?

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Differential Diagnosis

  • The patient presents with a complex set of symptoms, including sore throat, cough, sneezing, and 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 eye redness, crusting, and thick drainage, 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. The patient's recent history of strep pharyngitis and allergic rhinitis also exist, but the current symptoms are more consistent with a viral etiology.

Other Likely Diagnoses

  • Allergic Conjunctivitis: The patient's history of allergic rhinitis and the presence of sneezing and cough suggest that allergic conjunctivitis could be a contributing factor to her eye symptoms.
  • Viral Pharyngitis: The patient's sore throat and cough could be indicative of a viral pharyngitis, which is a common condition in adults.
  • Bacterial Conjunctivitis: Although the patient's symptoms are more consistent with a viral etiology, bacterial conjunctivitis is still a possibility, especially if the patient has a history of recurrent infections.

Do Not Miss Diagnoses

  • Epiglottitis: This is a rare but potentially life-threatening condition that can present with sore throat, cough, and difficulty swallowing. Although the patient's symptoms are not typical for epiglottitis, it is essential to consider this diagnosis to avoid missing a potentially deadly condition.
  • Orbital Cellulitis: This is a serious infection of the tissues surrounding the eye, which can present with eye redness, swelling, and discharge. Although the patient's symptoms are not severe enough to suggest orbital cellulitis, it is crucial to consider this diagnosis to avoid missing a potentially serious condition.

Rare Diagnoses

  • Kawasaki Disease: This is a rare condition that can present with conjunctural injection, rash, and lymphadenopathy. Although the patient's symptoms are not typical for Kawasaki disease, it is essential to consider this diagnosis in the differential diagnosis.
  • Gonococcal Conjunctivitis: This is a rare but potentially serious condition that can present with eye redness, discharge, and crusting. Although the patient's symptoms are not severe enough to suggest gonococcal conjunctivitis, it is crucial to consider this diagnosis to avoid missing a potentially serious condition.

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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