Differential Diagnosis
- Single most likely diagnosis
- Acute bronchitis: The patient's symptoms of cough, congestion, and production of green mucus are consistent with acute bronchitis, a common and typically self-limiting condition. The improvement and subsequent worsening of symptoms could be due to the natural fluctuation of the illness or the patient's decision to stop taking her blood pressure medication, which may have indirectly affected her overall condition.
- Other Likely diagnoses
- Upper respiratory tract infection (URTI): The patient's symptoms of cough, congestion, and body aches could also be indicative of a URTI, such as a cold or flu. The production of green mucus suggests a possible bacterial component, but this could also be seen in viral infections.
- Pneumonia: Although less likely given the patient's initial improvement, pneumonia is a possible diagnosis, especially if the patient has a compromised immune system or underlying lung disease. The production of green mucus and elevated blood pressure could be indicative of a more severe infection.
- Influenza: The patient's symptoms of cough, congestion, body aches, and feeling hot and cold could be consistent with influenza, especially during flu season.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Pulmonary embolism: Although the patient's symptoms do not strongly suggest pulmonary embolism, it is essential to consider this diagnosis, especially given the patient's elevated blood pressure and potential for cardiovascular disease.
- Sepsis: If the patient's condition worsens or she develops signs of sepsis, such as fever, tachycardia, or hypotension, this diagnosis must be considered and promptly addressed.
- Cardiac complications: The patient's elevated blood pressure and decision to stop taking her medication increase her risk for cardiac complications, such as myocardial infarction or heart failure.
- Rare diagnoses
- Tuberculosis: Although unlikely, tuberculosis could be considered if the patient has a history of exposure or underlying immunocompromised state.
- Fungal pneumonia: This diagnosis is rare but could be considered if the patient has a compromised immune system or underlying lung disease.
- Bronchiectasis: This chronic condition could be considered if the patient has a history of recurrent respiratory infections or underlying lung disease.