Differential Diagnosis for a 6-year-old Male with Worsening Cough and Fatigue for 9 Days
- Single most likely diagnosis:
- Viral upper respiratory infection (e.g., common cold): This is the most likely diagnosis given the age of the patient and the symptoms of worsening cough and fatigue, which are typical for a viral upper respiratory infection.
- Other Likely diagnoses:
- Acute bronchitis: This condition is characterized by a cough and can be caused by a viral or bacterial infection, making it a plausible diagnosis given the patient's symptoms.
- Pneumonia: Although less common, pneumonia is a possible diagnosis, especially if the patient has a fever, chest pain, or difficulty breathing, in addition to a worsening cough and fatigue.
- Asthma: If the patient has a history of asthma, an exacerbation could present with worsening cough and fatigue, especially if triggered by a respiratory infection.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.):
- Pertussis (whooping cough): Although vaccination has reduced its incidence, pertussis can still occur, especially in areas with low vaccination rates, and is characterized by a severe, persistent cough.
- Tuberculosis (TB): Although rare in children, TB is a critical diagnosis not to miss, as it requires specific treatment and can have severe consequences if left untreated.
- Pneumocystis jirovecii pneumonia (PCP): In immunocompromised children, PCP is a life-threatening condition that presents with respiratory symptoms, including cough and fatigue.
- Rare diagnoses:
- Cystic fibrosis: A genetic disorder that can present with recurrent respiratory infections and chronic cough, although it would typically be diagnosed earlier in life.
- Foreign body aspiration: Although more common in younger children, aspiration of a foreign body can occur at any age and presents with sudden onset of respiratory symptoms, including cough.
- Interstitial lung disease: A group of rare conditions that affect the lung tissue and can present with chronic cough and fatigue, among other symptoms.