Differential Diagnosis for a 17-year-old Male with Productive Cough
- Single most likely diagnosis:
- Acute bronchitis: This is the most likely diagnosis given the patient's symptoms of a productive cough that has worsened over 9 days, initially associated with sore throat and headache. The yellowish-green color of the sputum also supports this diagnosis, as it is consistent with a bacterial or viral infection.
- Other Likely diagnoses:
- Pneumonia: Although the patient does not report any fever, pneumonia is still a possible diagnosis, especially if the patient has a bacterial infection. The productive cough and worsening symptoms over time could be indicative of pneumonia.
- Influenza: Given the initial symptoms of sore throat and headache, influenza is a possible diagnosis, especially during flu season. However, the patient's symptoms have resolved except for the cough, which makes this diagnosis less likely.
- Bronchiolitis: Although more common in younger children, bronchiolitis can occur in adolescents, especially if they have a viral infection such as respiratory syncytial virus (RSV).
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.):
- Pulmonary embolism: Although rare in adolescents, pulmonary embolism can occur, especially if the patient has a history of trauma, surgery, or immobilization. A productive cough can be a symptom of pulmonary embolism, and it is essential to consider this diagnosis to avoid missing a life-threatening condition.
- Tuberculosis (TB): TB is a less common diagnosis, but it is essential to consider it, especially if the patient has been exposed to someone with TB or has traveled to an area with high TB prevalence. A productive cough that worsens over time could be indicative of TB.
- Cystic fibrosis: Although the patient denies any history of asthma or smoking, cystic fibrosis is a possible diagnosis, especially if the patient has a family history of the condition. A productive cough that worsens over time could be indicative of cystic fibrosis.
- Rare diagnoses:
- Bronchiectasis: This is a rare condition characterized by permanent dilation of the bronchi, which can cause a productive cough. However, it is less likely in an adolescent without a history of recurrent infections or underlying lung disease.
- Lung abscess: A lung abscess is a rare condition that can cause a productive cough, but it is usually associated with other symptoms such as fever, chest pain, and weight loss.