Differential Diagnosis for 62-year-old Female with Prolonged Cough and Respiratory Symptoms
- Single most likely diagnosis:
- Acute Exacerbation of Chronic Bronchitis: Given the patient's history of bronchitis, lack of improvement with antibiotics, and worsening symptoms, an acute exacerbation of chronic bronchitis is a likely diagnosis. The patient's age and prolonged cough also support this diagnosis.
- Other Likely diagnoses:
- Pneumonia: The patient's worsening cough, fever (38.3 °C), chills, and lack of improvement with previous treatments suggest pneumonia as a possible diagnosis.
- Influenza: The patient's symptoms, including cough, rhinorrhea, chills, sore throat, and headache, are consistent with influenza, especially given the acute onset of symptoms over the past 4 days.
- Sinusitis: The patient's nasal congestion, runny nose, and headache could indicate sinusitis, which may be contributing to her cough and other symptoms.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.):
- Lung Cancer: Although less likely, lung cancer should be considered in a patient with a prolonged cough, especially given her age and lack of response to previous treatments.
- Pulmonary Embolism: Although the patient's symptoms do not strongly suggest pulmonary embolism, it is a potentially life-threatening condition that should be considered, especially if she has risk factors such as immobility or recent surgery.
- Tuberculosis: Although less common, tuberculosis should be considered in a patient with a prolonged cough, especially if she has been exposed to someone with TB or has risk factors such as immunosuppression.
- Rare diagnoses:
- Sarcoidosis: This rare condition can cause prolonged cough, respiratory symptoms, and fever, although it is less likely given the patient's age and lack of other systemic symptoms.
- Histoplasmosis: This fungal infection can cause respiratory symptoms, including cough, fever, and headache, although it is relatively rare and typically associated with specific geographic or occupational exposures.