What is the likely diagnosis for an 11-year-old female with worsening pharyngitis and a history of strep throat?

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Differential Diagnosis for 11-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, wet cough, and nasal congestion, which are typical of a viral upper respiratory infection. The absence of fever and the recent history of seasonal allergies also support this diagnosis.
  • Other Likely diagnoses
    • Allergic pharyngitis: The patient's history of seasonal allergies and the presence of nasal congestion suggest that allergic pharyngitis could be a contributing factor to her sore throat.
    • Acute sinusitis: The patient's symptoms of nasal congestion and wet cough could also be indicative of acute sinusitis, which is often caused by a viral or bacterial infection.
    • Recurrent strep throat: Although the patient had a course of antibiotics for strep throat 5 months ago, it is possible that she could have contracted strep throat again, especially if she has been exposed to someone with the infection.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Epiglottitis: This is a rare but life-threatening condition that requires prompt diagnosis and treatment. Although the patient does not have any symptoms of difficulty swallowing or shortness of breath, epiglottitis should always be considered in the differential diagnosis of a sore throat.
    • Peritonsillar abscess: This is a serious complication of tonsillitis that can cause severe throat pain, difficulty swallowing, and fever. Although the patient does not have any of these symptoms, peritonsillar abscess should always be considered in the differential diagnosis of a sore throat.
    • Lemierre's syndrome: This is a rare but potentially life-threatening condition that is caused by a bacterial infection of the throat. It can cause symptoms such as sore throat, fever, and neck pain, and can lead to serious complications such as sepsis and thrombophlebitis.
  • Rare diagnoses
    • Infectious mononucleosis: This is a viral infection that can cause symptoms such as sore throat, fever, and fatigue. Although it is rare in children, it should be considered in the differential diagnosis of a sore throat, especially if the patient has been exposed to someone with the infection.
    • Gonococcal pharyngitis: This is a rare but potentially serious condition that is caused by a bacterial infection of the throat. It can cause symptoms such as sore throat, fever, and difficulty swallowing, and requires prompt diagnosis and treatment.

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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