Differential Diagnosis for a 44-year-old Female with Sore Throat and Hoarseness
- Single most likely diagnosis:
- Viral pharyngitis: This is the most likely diagnosis given the patient's symptoms of a mild sore throat, hoarseness, and cough, which are consistent with a viral upper respiratory infection. The negative rapid strep test and lack of fever also support this diagnosis.
- Other Likely diagnoses:
- Acute laryngitis: The patient's hoarseness and strained voice suggest inflammation of the larynx, which is often caused by a viral infection.
- Postnasal drip syndrome: The patient's symptoms of nasal congestion, rhinorrhea, and cough are consistent with postnasal drip syndrome, which can cause irritation of the throat and larynx.
- Allergic rhinitis: The patient's symptoms of nasal congestion and rhinorrhea could be related to allergies, which can also cause throat irritation and hoarseness.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.):
- Epiglottitis: Although the patient denies difficulty swallowing, epiglottitis is a life-threatening condition that requires prompt diagnosis and treatment. It can present with sore throat, hoarseness, and cough, and can progress rapidly to airway obstruction.
- Peritonsillar abscess: Although the rapid strep test is negative, a peritonsillar abscess is a serious condition that requires prompt diagnosis and treatment. It can present with severe sore throat, difficulty swallowing, and fever, but may not always have a positive rapid strep test.
- Laryngeal cancer: Although rare, laryngeal cancer can present with hoarseness and sore throat, and is more common in older adults. It is essential to consider this diagnosis, especially if the patient has a history of smoking or other risk factors.
- Rare diagnoses:
- Myasthenia gravis: This rare autoimmune disorder can cause weakness and fatigue of the vocal cords, leading to hoarseness and sore throat.
- Relapsing polychondritis: This rare autoimmune disorder can cause inflammation of the cartilage in the larynx and trachea, leading to hoarseness and sore throat.
- Sarcoidosis: This rare inflammatory disorder can cause granulomas to form in the larynx and other parts of the body, leading to hoarseness and sore throat.