What is the differential diagnosis of a cough?

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Last updated: May 16, 2025View editorial policy

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Cough Differential Diagnosis

The differential diagnosis for a cough can be organized into the following categories:

  • Single Most Likely Diagnosis
    • Acute bronchitis: This is the most common cause of cough, often resulting from a viral upper respiratory tract infection.
  • Other Likely Diagnoses
    • Asthma: A chronic inflammatory disease characterized by episodic airway constriction, often presenting with cough, wheezing, and shortness of breath.
    • Chronic obstructive pulmonary disease (COPD): A progressive lung disease causing chronic cough, wheezing, and shortness of breath, often associated with smoking.
    • Allergic rhinitis: An allergic reaction to airborne particles, such as pollen or dust, leading to cough, sneezing, and nasal congestion.
    • Gastroesophageal reflux disease (GERD): Stomach acid reflux into the esophagus, causing cough, heartburn, and chest pain.
  • Do Not Miss Diagnoses
    • Pneumonia: A potentially life-threatening infection of the lungs, requiring prompt antibiotic treatment.
    • Pulmonary embolism: A blood clot in the lungs, which can be fatal if not treated promptly.
    • Lung cancer: A malignant tumor in the lungs, often presenting with chronic cough, weight loss, and hemoptysis.
    • Tuberculosis: A bacterial infection of the lungs, requiring prolonged antibiotic treatment.
  • Rare Diagnoses
    • Cystic fibrosis: A genetic disorder causing chronic respiratory and digestive problems, often presenting with cough, wheezing, and malabsorption.
    • Sarcoidosis: An autoimmune disease causing inflammation in the lungs, lymph nodes, and other organs, often presenting with cough, shortness of breath, and fatigue.
    • Bronchiectasis: A condition characterized by permanent enlargement of the airways, often causing chronic cough, sputum production, and recurrent infections.
    • Angiotensin-converting enzyme (ACE) inhibitor-induced cough: A side effect of certain medications, such as ACE inhibitors, causing a dry, persistent cough.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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