Differential Diagnosis for Nasal Congestion and Sinus Pain
- Single most likely diagnosis:
- Chronic Sinusitis: This is the most likely diagnosis given the patient's symptoms of nasal congestion, colored drainage, and pain in the sinus area for 3 months. Chronic sinusitis is characterized by inflammation of the sinuses lasting more than 12 weeks, which aligns with the patient's duration of symptoms.
- Other Likely diagnoses:
- Allergic Rhinitis: This condition could also explain the patient's nasal congestion and drainage, especially if the patient has allergies. However, the presence of pain upon palpation of the sinus area and the duration of symptoms might lean more towards a sinusitis diagnosis.
- Acute Exacerbation of Chronic Sinusitis: If the patient has a history of chronic sinusitis, an acute exacerbation could present with increased symptoms of congestion, drainage, and pain, making this a plausible diagnosis.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.):
- Sinus Cancer: Although rare, sinus cancer can present with similar symptoms of nasal congestion and sinus pain. It's crucial to consider this diagnosis, especially if there are additional symptoms like unilateral nasal obstruction, bleeding, or significant weight loss.
- Orbital Cellulitis: This is an infection of the tissues surrounding the eye and can be a complication of sinusitis. Symptoms might include pain, swelling, and redness around the eye, which could be life-threatening if not promptly treated.
- Cavernous Sinus Thrombosis: A rare but potentially life-threatening condition that can arise from sinus infections, characterized by the formation of a blood clot in the cavernous sinus. Symptoms can include severe headache, fever, and neurological deficits.
- Rare diagnoses:
- Wegener's Granulomatosis (Granulomatosis with Polyangiitis): A rare autoimmune disorder that can affect the sinuses, lungs, and kidneys, presenting with symptoms of sinusitis, among others.
- Fungal Sinusitis: More common in immunocompromised patients, fungal sinusitis can present with similar symptoms of chronic sinusitis but requires specific treatment.