Differential Diagnosis for 22-year-old Female with Respiratory Symptoms
- Single most likely diagnosis:
- Acute bronchitis: This is the most likely diagnosis given the patient's symptoms of productive cough, wheezing, nasal congestion, and rhinorrhea, which are consistent with a viral upper respiratory infection. The lack of improvement with over-the-counter medications and the absence of a past medical history of asthma also support this diagnosis.
- Other Likely diagnoses:
- Viral upper respiratory infection (URI): The patient's symptoms of cough, wheezing, nasal congestion, and rhinorrhea are consistent with a viral URI.
- Allergic rhinitis: The patient's symptoms of nasal congestion and rhinorrhea could be related to allergic rhinitis, especially if she has allergies that are exacerbated by her daily marijuana use.
- Chronic bronchitis: The patient's daily marijuana use could be contributing to chronic bronchitis, which may present with similar symptoms to acute bronchitis.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.):
- Pneumonia: Although the patient's symptoms are more consistent with an upper respiratory infection, pneumonia is a potentially life-threatening condition that must be considered, especially if the patient has a high fever, difficulty breathing, or other concerning symptoms.
- Pulmonary embolism: This is a rare but potentially life-threatening condition that can present with sudden onset of cough, wheezing, and shortness of breath.
- Asthma: Although the patient denies a past medical history of asthma, it is possible that she has undiagnosed asthma, which could be triggered by her marijuana use or other environmental factors.
- Rare diagnoses:
- Cystic fibrosis: This is a rare genetic disorder that can present with chronic respiratory symptoms, including cough and wheezing.
- Bronchiectasis: This is a rare condition characterized by permanent dilation of the bronchi, which can present with chronic cough and wheezing.
- Immunodeficiency: The patient's lack of response to over-the-counter medications and her daily marijuana use could be related to an underlying immunodeficiency, which would increase her risk of developing rare and opportunistic infections.