Differential Diagnosis for Charles Booth
As a primary care physician (PCP), considering Charles Booth's symptoms and history, the following differential diagnoses are possible:
- Single most likely diagnosis
- Losartan-induced cough: The patient's cough started after an incident of burning plastic, but it's also important to note that he has been taking losartan, an angiotensin II receptor antagonist, which is known to cause a dry, hacky cough in some patients, similar to ACE inhibitors. The temporal relationship between the cough and the medication, rather than the incident, could be a contributing factor.
- Other Likely diagnoses
- Acute respiratory distress syndrome (ARDS) sequelae: Although the chest X-rays were negative, the history of inhaling smoke from burning plastic could have caused lung damage, potentially leading to chronic respiratory symptoms like a cough.
- Chronic obstructive pulmonary disease (COPD): Given the patient's age and history of exposure to smoke, COPD is a possibility, especially if he has a history of smoking or other respiratory irritants.
- Asthma: The cough could be a symptom of asthma, especially if triggered by the inhalation of smoke or other irritants.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Lung cancer: Although the chest X-rays were negative, it's essential to consider lung cancer, especially given the patient's age and potential exposure to carcinogens from burning plastic.
- Sarcoidosis: This condition can cause a chronic cough and can be triggered by exposure to environmental irritants.
- Pulmonary fibrosis: The patient's history of inhaling smoke could have caused lung damage, potentially leading to pulmonary fibrosis.
- Rare diagnoses
- Hypersensitivity pneumonitis: This is a rare condition caused by an allergic reaction to inhaled substances, which could be a possibility given the patient's exposure to smoke from burning plastic.
- Bronchiolitis obliterans: This is a rare condition characterized by inflammation and obstruction of the small airways, which could be caused by inhalation of toxic substances.