Differential Diagnosis for 69-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, nasal congestion, postnasal drip, body aches, chills, and sinus pressure. The worsening of symptoms over 2 weeks and the lack of improvement with over-the-counter Tylenol also support this diagnosis.
- Other Likely diagnoses:
- Sinusitis: The patient's symptoms of sinus pressure, nasal congestion, and postnasal drip suggest sinusitis as a possible diagnosis. The productive cough and body aches also support this diagnosis.
- Influenza: Although the patient does not report a high fever, the symptoms of body aches, chills, and cough are consistent with influenza. The fact that the symptoms have worsened over 2 weeks also supports this diagnosis.
- Pneumonia: The patient's symptoms of cough, body aches, and chills could be consistent with pneumonia, especially if the cough is productive and worsening over time.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.):
- Pulmonary Embolism: Although the patient denies chest pain, the cough can be painful at times, and the increased cough with deep breathing and talking could be consistent with a pulmonary embolism. This diagnosis is critical to consider due to its high mortality rate if missed.
- Lung Cancer: The patient's age and worsening cough over 2 weeks could be consistent with lung cancer. Although this diagnosis is less likely, it is essential to consider due to its potential severity and impact on treatment.
- Rare diagnoses:
- Tuberculosis: Although less common, tuberculosis could present with similar symptoms, including cough, body aches, and chills. This diagnosis is essential to consider, especially if the patient has a history of exposure or travel to endemic areas.
- Sarcoidosis: This rare autoimmune disease could present with respiratory symptoms, including cough and sinus pressure. Although less likely, it is essential to consider in the differential diagnosis due to its potential impact on treatment and management.