Differential Diagnosis for Nasal Congestion and Petechiae in a Carpenter
- Single most likely diagnosis:
- Wegener's Granulomatosis (Granulomatosis with Polyangiitis, GPA): This condition is a form of vasculitis that affects small- and medium-sized vessels and is known for its association with respiratory tract symptoms (like nasal congestion) and systemic symptoms including petechiae. The occupational exposure to dust and other irritants as a carpenter could exacerbate respiratory symptoms.
- Other Likely diagnoses:
- Infectious diseases (e.g., endocarditis, sepsis): These conditions can cause petechiae due to embolic phenomena or disseminated intravascular coagulation and may also lead to systemic symptoms including nasal congestion due to inflammation or infection.
- Allergic reactions or allergic rhinitis: While less likely to cause petechiae, severe allergic reactions could potentially lead to both nasal congestion and, in rare cases, petechiae through mechanisms like increased vascular permeability.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.):
- Leukemia or lymphoma: These malignancies can cause petechiae due to thrombocytopenia or platelet dysfunction and may also lead to nasal congestion through infiltration of the nasal passages or secondary infections.
- Disseminated intravascular coagulation (DIC): A condition characterized by both widespread clotting and bleeding, which can lead to petechiae and potentially to respiratory symptoms if there is pulmonary involvement.
- Rare diagnoses:
- Churg-Strauss Syndrome (Eosinophilic Granulomatosis with Polyangiitis, EGPA): Another form of vasculitis that can present with asthma, eosinophilia, and vasculitic symptoms including petechiae and nasal congestion.
- Goodpasture's Syndrome: An autoimmune disease that can cause pulmonary and renal symptoms due to anti-GBM antibodies, potentially leading to nasal congestion and, less commonly, petechiae if there is significant vascular involvement.