Differential Diagnosis for 27-year-old Female Patient
Single Most Likely Diagnosis
- Post-viral syndrome or upper respiratory infection: The patient's symptoms of persistent nasal congestion, rhinorrhea, cough, and recent loss of taste and smell after a fever and sore throat suggest a viral upper respiratory infection that is resolving but leaving residual symptoms. The negative rapid influenza and COVID tests support this, as many other viruses can cause similar symptoms.
Other Likely Diagnoses
- Common cold: Given the symptoms of nasal congestion, rhinorrhea, and cough, a common cold is a plausible diagnosis, especially since the patient's fever and sore throat have resolved.
- Allergic rhinitis: If the patient is exposed to allergens, her symptoms of nasal congestion and rhinorrhea could be exacerbated or primarily caused by an allergic reaction.
- Sinusitis: The persistence of nasal congestion and cough could indicate the development of sinusitis, especially if the patient's symptoms worsen or do not improve with time.
Do Not Miss Diagnoses
- COVID-19 (despite negative test): False negatives can occur, especially if the test is taken too early in the course of the illness. The loss of taste and smell is a significant red flag for COVID-19.
- Influenza (despite negative test): Similar to COVID-19, false negatives can occur, and influenza can present with a wide range of symptoms including those the patient is experiencing.
- Mononucleosis: Although less common in adults, mononucleosis can cause prolonged fever, sore throat, and fatigue, and it's essential to consider it, especially if the patient's symptoms do not resolve as expected.
- Pertussis (Whooping Cough): This bacterial infection can cause a persistent cough and is a critical diagnosis to consider, especially in a healthcare worker who could be exposed to or spread the infection to vulnerable populations.
Rare Diagnoses
- Viral parosmia: A condition where there's a distortion of the sense of smell, which could explain the patient's recent loss of taste and smell, although this would be an uncommon presentation.
- Autoimmune disorders: Certain autoimmune conditions can cause a wide range of symptoms including those similar to what the patient is experiencing, though these would be less likely without other supporting symptoms or history.