Differential Diagnosis for 53-year-old Female with Sore Throat and Productive Cough
- Single most likely diagnosis:
- Viral pharyngitis: The patient's symptoms of sore throat, productive cough, and fever, along with negative rapid strep, COVID, and influenza tests, suggest a viral etiology. The mild improvement in sore throat and response to Advil and Tylenol also support this diagnosis.
- Other Likely diagnoses:
- Acute bronchitis: The development of a productive cough and fever suggests a lower respiratory tract infection, which could be acute bronchitis.
- Viral laryngitis: The patient's initial "razor blade" sensation with swallowing could indicate involvement of the larynx, making viral laryngitis a possible diagnosis.
- 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 prompt recognition and treatment. The patient's severe sore throat and difficulty swallowing could be indicative of epiglottitis.
- Peritonsillar abscess: A complication of tonsillitis, peritonsillar abscess can cause severe throat pain, difficulty swallowing, and fever. Although the rapid strep test was negative, a peritonsillar abscess is still possible.
- Lemierre's syndrome: A rare but potentially life-threatening condition, Lemierre's syndrome is characterized by a sore throat, fever, and neck pain, followed by sepsis and thrombophlebitis.
- Rare diagnoses:
- Infectious mononucleosis: Although the patient's age is not typical for infectious mononucleosis, it is still possible, especially if she has been exposed to someone with the infection.
- Diphtheria: A rare but serious bacterial infection, diphtheria can cause a sore throat, cough, and fever, although it is unlikely in a vaccinated individual.