Differential Diagnosis for 72-year-old Male with Respiratory Symptoms
- Single most likely diagnosis:
- Viral upper respiratory tract infection (URTI): The patient's symptoms of nasal congestion, rhinorrhea, and cough, along with a reported mild improvement, are consistent with a viral URTI, which is a common and self-limiting condition.
- Other Likely diagnoses:
- Acute bronchitis: Given the patient's cough and chest congestion, acute bronchitis is a possible diagnosis, especially since he has shown some improvement.
- Allergic rhinitis: The patient's symptoms of nasal congestion and rhinorrhea could also be indicative of allergic rhinitis, although the duration and lack of specific allergen exposure make this less likely.
- Sinusitis: The patient's symptoms of nasal congestion and rhinorrhea could be consistent with sinusitis, although the absence of facial pain or purulent discharge makes this less likely.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.):
- Pneumonia: Although the patient denies shortness of breath or chest pain and has shown some improvement, pneumonia is a critical diagnosis to consider, especially in an elderly patient with significant past medical history.
- Pulmonary embolism: Given the patient's history of coronary artery disease and mitral valve regurgitation, pulmonary embolism is a potential diagnosis that must be considered, although the lack of shortness of breath or chest pain makes it less likely.
- Cardiac exacerbation (e.g., heart failure or myocardial infarction): The patient's significant past medical history of coronary artery disease, mitral valve regurgitation, and hypertension necessitates consideration of cardiac exacerbation, although the absence of chest pain or shortness of breath makes this less likely.
- Rare diagnoses:
- Influenza: Although the patient's symptoms could be consistent with influenza, the lack of specific mention of fever, myalgias, or other systemic symptoms makes this less likely.
- Tuberculosis: Given the patient's age and symptoms, tuberculosis is a rare but possible diagnosis, although the lack of systemic symptoms, weight loss, or night sweats makes this unlikely.