Differential Diagnosis for 14-year-old Male with Respiratory Symptoms

• Single most likely diagnosis:
  • Influenza: The patient's symptoms of fever, body aches, sore throat, productive cough, and nasal congestion, which have worsened over time, are consistent with influenza, especially given the recent onset and the lack of improvement with over-the-counter medications.
• Other Likely diagnoses:
  • Common Cold (Rhinovirus): Although the patient describes his symptoms as starting like a common cold, the progression and severity, including fever and body aches, suggest a more severe infection.
  • Acute Sinusitis: The patient's symptoms of increasing nasal congestion, rhinorrhea, and productive cough could indicate acute sinusitis, especially if the symptoms persist or worsen over time.
  • Acute Bronchitis: Given the patient's history of asthma and the presence of a productive cough, acute bronchitis is a consideration, though the absence of a more prominent cough at the outset makes it less likely.
• Do Not Miss (ddxs that may not be likely, but would be deadly if missed.):
  • Bacterial Pneumonia: Although less likely given the initial presentation, bacterial pneumonia can present with similar symptoms and is a critical diagnosis not to miss due to its potential severity and need for antibiotic treatment.
  • Epiglottitis: This condition, although rare, is a medical emergency that can present with severe sore throat, difficulty swallowing, and high fever, and requires prompt recognition and treatment.
  • Pertussis (Whooping Cough): Given the patient's cough and the fact that pertussis can present with symptoms similar to a common cold initially, it's crucial to consider, especially if the cough becomes more characteristic or if there's exposure history.
• Rare diagnoses:
  • Mycoplasma Pneumonia: This atypical pneumonia can present with symptoms similar to those described, including fever, cough, and body aches, and is more common in school-aged children and young adults.
  • Adenoviral Infection: The presence of bilateral conjunctivitis with the other symptoms could suggest an adenoviral infection, which can cause a range of symptoms including respiratory and ocular manifestations.