Differential Diagnosis for Ear Pain, Headache, Nasal Congestion, and Cough
Single Most Likely Diagnosis
- Viral Upper Respiratory Tract Infection (URTI): This is the most likely diagnosis given the combination of symptoms such as ear pain, headache, nasal congestion, and cough. The lack of relief from using a netti pot and the duration of symptoms for 3 days also support this diagnosis, as viral infections often do not respond to nasal irrigation alone and can last for several days to over a week.
Other Likely Diagnoses
- Sinusitis: Given the nasal congestion and the fact that the netti pot did not provide relief, sinusitis is a plausible diagnosis. It can be acute or chronic and is often caused by a bacterial infection following a viral upper respiratory infection.
- Allergic Rhinitis: If the symptoms are seasonal or triggered by specific allergens, allergic rhinitis could be a likely diagnosis. However, the presence of a cough and the lack of mention of typical allergic symptoms like itchy eyes or sneezing make this less likely.
- Common Cold: Similar to viral URTI, the common cold presents with similar symptoms but is more focused on the upper respiratory tract without the systemic symptoms like fever and body aches that can accompany more severe viral infections.
Do Not Miss Diagnoses
- Bacterial Meningitis: Although rare, bacterial meningitis is a life-threatening condition that can present with headache, fever, and sometimes ear pain or nasal congestion if there's associated sinusitis. It requires immediate medical attention.
- Temporal Arteritis (Giant Cell Arteritis): This condition, more common in older adults, can cause headache and ear pain due to inflammation of the temporal arteries. It's a medical emergency due to the risk of vision loss.
- Lymphoma or Other Malignancies: In rare cases, persistent or severe symptoms could be indicative of a malignancy affecting the sinuses, nasal passages, or lymph nodes in the neck.
Rare Diagnoses
- Tuberculosis (TB): TB can present with a variety of symptoms including cough, and less commonly, ear pain or nasal congestion if it affects the lungs and spreads to other areas.
- Fungal Sinusitis: More common in immunocompromised individuals, fungal sinusitis can cause similar symptoms to bacterial sinusitis but requires specific treatment.
- Relapsing Polychondritis: A rare autoimmune disorder that can cause cartilage inflammation, leading to ear pain, nasal congestion, and other symptoms affecting cartilaginous structures.