Differential Diagnosis for 47-year-old Female with Sore Throat and Fatigue
- Single most likely diagnosis:
- Viral pharyngitis: This is the most likely diagnosis given the acute onset of sore throat, postnasal drainage, and headache, especially with a negative rapid strep test. The symptoms are consistent with a viral upper respiratory infection.
- Other Likely diagnoses:
- Acute sinusitis: The patient's symptoms of postnasal drainage, headache described as a typical sinus headache, and sore throat could also suggest acute sinusitis, especially given her history of seasonal allergies which could predispose her to sinus infections.
- Influenza: Although not specifically mentioned, the sudden onset of fatigue, sore throat, and headache could be indicative of influenza, particularly during flu season.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.):
- Epiglottitis: Although rare, epiglottitis is a life-threatening condition that requires immediate attention. Symptoms can include severe sore throat, difficulty swallowing, and shortness of breath. It's crucial to consider this diagnosis, especially if the patient's condition worsens or if she exhibits signs of respiratory distress.
- Lemierre's syndrome: This is a rare but serious condition that typically follows a sore throat, characterized by jugular vein thrombosis and septicemia. It's essential to consider in patients with severe pharyngitis who do not improve with standard treatment.
- Peritonsillar abscess: Although the rapid strep test was negative, a peritonsillar abscess could still be a consideration, especially if the patient has severe throat pain, difficulty swallowing, or fever. This condition requires prompt medical attention.
- Rare diagnoses:
- Mononucleosis (mono): Caused by the Epstein-Barr virus, mono can present with sore throat, fatigue, and headache. It's more common in younger populations but can occur at any age.
- Human immunodeficiency virus (HIV) acute infection: In some cases, the initial presentation of HIV infection can include sore throat, fever, and fatigue, among other symptoms. This diagnosis would be considered if the patient has risk factors for HIV exposure.