What is the diagnosis for a 79-year-old female with a 2-week history of productive cough and nasal congestion without chest pain, shortness of breath, fever, or weakness?

Differential Diagnosis for 79-year-old Female with Persistent Cough and Respiratory Symptoms

Single Most Likely Diagnosis

• Acute Bronchitis: This is the most likely diagnosis given the patient's symptoms of persistent cough, nasal congestion, raspy voice, and fatigue, which began 2 weeks ago. The presence of a productive cough with yellowish sputum further supports this diagnosis, as acute bronchitis is often characterized by a productive cough.

Other Likely Diagnoses

• Upper Respiratory Tract Infection (URTI): The patient's symptoms of nasal congestion, raspy voice, and cough could also be indicative of an upper respiratory tract infection, which is a common cause of similar symptoms in the elderly.
• Chronic Obstructive Pulmonary Disease (COPD) Exacerbation: Although the patient denies shortness of breath, COPD exacerbation could still be a consideration, especially if the patient has a history of COPD, given the age and symptoms of cough and fatigue.
• Asthma: Asthma could be another possibility, especially if the patient has a history of asthma or atopy, given the symptoms of cough, raspy voice, and fatigue.

Do Not Miss Diagnoses

• Pneumonia: Although the patient denies fever, pneumonia is a potentially life-threatening condition that should not be missed, especially in the elderly. The presence of a productive cough with yellowish sputum increases the suspicion for pneumonia.
• Lung Cancer: Given the patient's age and symptoms of persistent cough and fatigue, lung cancer is a diagnosis that should not be missed, although it may be less likely.
• Pulmonary Embolism: Although the patient denies chest pain and shortness of breath, pulmonary embolism is a potentially life-threatening condition that should be considered, especially if the patient has risk factors such as immobility or history of deep vein thrombosis.

Rare Diagnoses

• Tuberculosis (TB): TB is a rare diagnosis in the elderly, but it should be considered, especially if the patient has a history of exposure or travel to endemic areas.
• Sarcoidosis: Sarcoidosis is a rare condition that can cause respiratory symptoms, including cough and fatigue, although it is less likely in this patient.
• Histoplasmosis: Histoplasmosis is a rare fungal infection that can cause respiratory symptoms, including cough and fatigue, although it is less likely in this patient.