Differential Diagnosis for a 78-year-old Male with Sore Throat and Cough
Single Most Likely Diagnosis
- Acute Viral Pharyngitis: This is the most common cause of sore throat and cough in adults, often caused by viruses such as rhinovirus, coronavirus, or adenovirus. The symptoms presented are typical for this condition, and the age of the patient does not significantly alter the likelihood of this diagnosis.
Other Likely Diagnoses
- Acute Bacterial Pharyngitis: Although less common than viral pharyngitis, bacterial causes such as Group A beta-hemolytic streptococcus (GABHS) can cause sore throat and cough. The patient's age and duration of symptoms could suggest a bacterial etiology, especially if symptoms persist or worsen.
- Acute Bronchitis: This condition, often caused by viral infections, can present with cough and may be accompanied by sore throat due to postnasal drip. The patient's age and symptoms are consistent with this diagnosis.
- Influenza: Given the symptoms of sore throat and cough, especially during influenza season, this diagnosis should be considered, particularly in older adults who are at higher risk for complications.
Do Not Miss Diagnoses
- Pneumonia: Although the primary symptoms are sore throat and cough, pneumonia can present atypically in older adults, with less typical symptoms such as sore throat or mild cough. It is crucial to consider this diagnosis due to the high risk of morbidity and mortality in this age group.
- Epiglottitis: This is a life-threatening condition that can cause sore throat and cough, among other symptoms like difficulty swallowing and shortness of breath. Although rare, it requires immediate medical attention.
- Lung Cancer: In an older adult with a new onset of cough, it is essential to consider malignancy, especially if the patient has a history of smoking or other risk factors.
Rare Diagnoses
- Tuberculosis (TB): While less common in many parts of the world, TB can cause chronic cough and sore throat. It should be considered, especially if the patient has risk factors such as immunocompromised status or recent travel to areas with high TB prevalence.
- Pertussis (Whooping Cough): Although primarily a pediatric disease, pertussis can occur in adults, especially if vaccination status is incomplete. It typically causes a severe cough but can be accompanied by sore throat.
- Diphtheria: A rare bacterial infection that can cause sore throat and cough, diphtheria is more common in areas with low vaccination rates but should be considered in travelers or those with incomplete vaccination.