Differential Diagnosis for Progressive Shortness of Breath
Single Most Likely Diagnosis
- Idiopathic Pulmonary Fibrosis (IPF): The patient's symptoms of progressive shortness of breath, mild rales in the bases, and bibasilar peripheral reticular abnormalities on chest radiograph are consistent with IPF. The patient's occupation in a cabinet-making shop may also expose him to dust, which could be a contributing factor.
Other Likely Diagnoses
- Hypersensitivity Pneumonitis: The patient's occupation in a cabinet-making shop exposes him to various dusts and chemicals, which could trigger an immune response leading to hypersensitivity pneumonitis.
- Chronic Eosinophilic Pneumonia: This condition could present with similar symptoms and radiographic findings, although it is less common.
- Sarcoidosis: Although less likely, sarcoidosis could present with pulmonary symptoms and radiographic abnormalities, especially if the patient has other systemic symptoms.
Do Not Miss Diagnoses
- Lung Cancer: Although the patient has never smoked, lung cancer can still occur, and it is essential to consider it, especially if there are any abnormalities on the chest radiograph or if the patient has a family history.
- Pulmonary Embolism: This is a life-threatening condition that can present with acute or progressive shortness of breath, and it is crucial to rule it out, especially if the patient has any risk factors for thromboembolism.
- Cardiac Disease: Cardiac conditions such as heart failure or coronary artery disease can present with shortness of breath, and it is essential to consider them, especially if the patient has any cardiac risk factors.
Rare Diagnoses
- Lymphangitic Carcinomatosis: This is a rare condition characterized by the spread of cancer to the lymphatic vessels in the lungs, which can present with similar symptoms and radiographic findings.
- Pulmonary Langerhans Cell Histiocytosis: This is a rare condition that can present with pulmonary symptoms and radiographic abnormalities, especially in smokers, although it can also occur in non-smokers.
- Pulmonary Alveolar Proteinosis: This is a rare condition characterized by the accumulation of protein and phospholipids in the alveoli, which can present with similar symptoms and radiographic findings.