Differential Diagnosis for 18-year-old Female with Sore Throat
- Single most likely diagnosis
- Viral Pharyngitis: This is the most likely diagnosis given the patient's symptoms of sore throat, erythematous tonsils, and pain with swallowing, without any systemic symptoms like fever or cough. The absence of recent infection and the patient's ability to tolerate oral liquids and solids also support this diagnosis.
- Other Likely diagnoses
- Streptococcal Pharyngitis: Although the patient denies fever, this condition is still a possibility, especially given the presence of erythematous tonsils. A rapid streptococcal antigen test or throat culture may be necessary to confirm the diagnosis.
- Infectious Mononucleosis: This condition can cause sore throat, tonsillitis, and fever, although the patient denies fever. It's still a consideration, especially in a young adult.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Epiglottitis: Although rare, this condition can be life-threatening if not recognized promptly. The patient's symptoms of sore throat and pain with swallowing could be indicative of epiglottitis, especially if there's significant swelling of the epiglottis.
- Peritonsillar Abscess: This condition can cause severe throat pain, difficulty swallowing, and fever. Although the patient denies fever, a peritonsillar abscess is still a possibility and requires prompt evaluation and treatment.
- Lemierre's Syndrome: This rare condition is characterized by a sore throat, followed by neck pain, and can lead to serious complications like sepsis and thrombophlebitis.
- Rare diagnoses
- Diphtheria: This bacterial infection can cause a sore throat, cough, and difficulty breathing, although it's rare in developed countries due to vaccination.
- Gonococcal Pharyngitis: This condition can cause a sore throat, especially in sexually active individuals, and requires prompt treatment to prevent complications.
- Tuberculous Pharyngitis: This rare condition can cause a chronic sore throat, cough, and weight loss, and requires a high index of suspicion for diagnosis.