Differential Diagnosis for 52-year-old Male with Respiratory Symptoms
- Single most likely diagnosis
- Asthma exacerbation: The patient has a past medical history of asthma and presents with symptoms of cough, wheezing, and chest tightness, which are classic for an asthma exacerbation. The fact that he has not been using his Advair as prescribed and has been relying on albuterol as needed suggests poor control of his asthma, making an exacerbation more likely.
- Other Likely diagnoses
- Allergic rhinitis: The patient reports a history of seasonal allergies and believes his allergies have been acting up, which could be contributing to his symptoms of rhinorrhea and potentially exacerbating his asthma.
- Upper respiratory infection: The patient's symptoms of cough, wheezing, and rhinorrhea could also be consistent with an upper respiratory infection, such as a cold or viral bronchitis.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Pneumonia: Although the patient's symptoms are more consistent with asthma or an upper respiratory infection, pneumonia is a potentially life-threatening condition that must be considered, especially if the patient has a fever, shortness of breath, or other concerning symptoms.
- Pulmonary embolism: This is a less likely diagnosis, but it is a life-threatening condition that can present with sudden onset of chest tightness and shortness of breath, making it a "do not miss" diagnosis.
- Cardiac disease (e.g. acute coronary syndrome): The patient's symptoms of chest tightness could also be consistent with cardiac disease, such as acute coronary syndrome, which would be a medical emergency.
- Rare diagnoses
- Churg-Strauss syndrome: This is a rare autoimmune disorder that can present with asthma-like symptoms, as well as other systemic symptoms such as fever and weight loss.
- Hypersensitivity pneumonitis: This is a rare lung disease caused by an allergic reaction to inhaled substances, which can present with symptoms similar to asthma or pneumonia.