Differential Diagnosis for Sore Throat, Left Eye Crusted Shut and Red, Cough, Congestion in a 21-Year-Old
Single Most Likely Diagnosis
- Viral Pharyngitis with Conjunctivitis: This is the most likely diagnosis given the combination of sore throat, cough, congestion, and eye symptoms. Viral infections such as adenovirus can cause both pharyngitis and conjunctivitis, leading to the symptoms described.
Other Likely Diagnoses
- Bacterial Pharyngitis (Strep Throat): Although less likely than viral pharyngitis due to the presence of conjunctivitis, bacterial pharyngitis caused by Group A beta-hemolytic streptococcus (GABHS) is a common cause of sore throat in young adults and should be considered.
- Influenza: Influenza can cause sore throat, cough, and congestion, and while it's less commonly associated with conjunctivitis, it's a plausible diagnosis, especially during flu season.
- Allergic Rhinitis: Allergic reactions could lead to congestion and cough, and if the allergen also affects the eyes, it could explain the crusted, red eye. However, the sore throat might be less directly related.
Do Not Miss Diagnoses
- Meningitis: Although rare, meningitis is a life-threatening condition that can initially present with non-specific symptoms such as sore throat, cough, and fever. The presence of a severe headache, stiff neck, or altered mental status would increase suspicion.
- Peritonsillar Abscess: A complication of bacterial pharyngitis, a peritonsillar abscess can cause severe throat pain and is a medical emergency. However, it typically presents with more localized symptoms such as a severely sore throat on one side and difficulty swallowing.
- Lemierre's Syndrome: A rare but serious condition that starts with pharyngitis and can progress to septicemia and thrombophlebitis of the internal jugular vein. It's characterized by a high fever, sore throat, and neck pain.
Rare Diagnoses
- Diphtheria: A rare bacterial infection in developed countries due to vaccination, diphtheria can cause a sore throat and a membrane to form in the throat. It's less likely but should be considered in unvaccinated individuals or those who have traveled to areas where diphtheria is common.
- Kawasaki Disease: Although more common in children, Kawasaki disease can occur in young adults and presents with fever, conjunctivitis, and other symptoms. It's a rare cause of the symptoms described but is important to consider due to its potential for cardiac complications.
- Gonococcal Conjunctivitis and Pharyngitis: In sexually active individuals, gonococcal infection can cause conjunctivitis and pharyngitis. This diagnosis would be considered based on sexual history and risk factors.