Differential Diagnosis for 5-Day Cough, Rhinorrhea, and Sinus Pressure
Single Most Likely Diagnosis
- Viral Upper Respiratory Tract Infection (URTI): This is the most common cause of cough, rhinorrhea, and sinus pressure, often resulting from viruses such as rhinovirus, coronavirus, or influenza. The symptoms presented are typical for a self-limiting viral infection.
Other Likely Diagnoses
- Acute Sinusitis: Often follows a viral upper respiratory infection, with symptoms including facial pain, nasal congestion, and purulent nasal discharge. Bacterial sinusitis is a consideration if symptoms worsen or persist beyond 7-10 days.
- Allergic Rhinitis: Can present with similar symptoms, including rhinorrhea and sinus pressure, especially if exposure to allergens has increased. Seasonal variation and presence of other allergic symptoms (like itchy eyes) can help differentiate.
- Influenza: Especially during flu season, influenza can cause these symptoms, often accompanied by fever, body aches, and a more abrupt onset compared to other viral URTIs.
Do Not Miss Diagnoses
- Pneumonia: Although less likely with the symptoms provided, pneumonia can present with cough and, in some cases, rhinorrhea if there's an associated viral upper respiratory component. It's crucial to consider, especially in vulnerable populations (e.g., the elderly, young children, or those with compromised immune systems).
- Pertussis (Whooping Cough): Characterized by a persistent cough, which can be accompanied by rhinorrhea and sinus pressure in the early stages. The classic "whoop" sound may not always be present, especially in adults or partially vaccinated individuals.
- COVID-19: Given its global impact, COVID-19 should be considered, especially if there's a history of exposure or travel. Early symptoms can mimic those of a viral URTI.
Rare Diagnoses
- Wegener's Granulomatosis (Granulomatosis with Polyangiitis): A rare autoimmune disorder that can cause sinusitis, cough, and other systemic symptoms. It's much less common but should be considered if symptoms are severe, persistent, or accompanied by other systemic signs like kidney issues or skin lesions.
- Tuberculosis: Although rare in many parts of the world, TB can cause chronic cough and sinus symptoms among other systemic signs. It's more likely in individuals with risk factors such as immunocompromise or recent travel to/endemic areas.
- Fungal Sinusitis: More common in immunocompromised patients, fungal sinusitis can cause similar symptoms and requires prompt diagnosis and treatment to prevent serious complications.