Differential Diagnosis

• Single most likely diagnosis:
  • Pneumonia: This is often the most common diagnosis in patients presenting with respiratory symptoms such as cough, fever, and shortness of breath. The justification for this diagnosis is based on the high prevalence of pneumonia in the population and its potential to cause severe illness if left untreated.
• Other Likely diagnoses:
  • Asthma: This condition is characterized by episodic airway constriction, often triggered by allergens or respiratory infections. It is a likely diagnosis in patients with recurrent wheezing, cough, and shortness of breath.
  • Chronic Obstructive Pulmonary Disease (COPD): COPD is a progressive lung disease that can cause symptoms such as shortness of breath, wheezing, and chronic cough. It is a likely diagnosis in patients with a history of smoking or exposure to lung irritants.
• Do Not Miss diagnoses:
  • Pulmonary Embolism: Although less common, pulmonary embolism is a life-threatening condition that requires immediate attention. It can present with sudden onset of shortness of breath, chest pain, and cough.
  • Pneumothorax: This condition, characterized by air in the pleural space, can cause sudden chest pain and shortness of breath. It is a medical emergency that requires prompt diagnosis and treatment.
• Rare diagnoses:
  • Cystic Fibrosis: This genetic disorder affects the respiratory, digestive, and reproductive systems, causing symptoms such as chronic cough, wheezing, and recurrent lung infections. It is a rare diagnosis, but important to consider in patients with persistent respiratory symptoms.
  • Sarcoidosis: This inflammatory disease can affect multiple organs, including the lungs, causing symptoms such as cough, shortness of breath, and chest pain. It is a rare diagnosis, but should be considered in patients with unexplained respiratory symptoms.

Treatment Options for the 3 Most Likely Diagnoses

1. Pneumonia:
   • Antibiotics (e.g., azithromycin, amoxicillin) for bacterial pneumonia
   • Antivirals (e.g., oseltamivir) for viral pneumonia
   • Supportive care, including oxygen therapy, hydration, and rest
2. Asthma:
   • Bronchodilators (e.g., albuterol) for acute symptoms
   • Inhaled corticosteroids (e.g., fluticasone) for long-term control
   • Avoidance of triggers and allergens
3. COPD:
   • Bronchodilators (e.g., salmeterol, tiotropium) for symptom management
   • Inhaled corticosteroids (e.g., fluticasone) for patients with frequent exacerbations
   • Pulmonary rehabilitation and smoking cessation programs for patients with COPD.