Differential Diagnosis
The patient presents with allergy-like symptoms, asthma flare-up, and respiratory issues. Here's a categorized differential diagnosis:
- Single most likely diagnosis
- Asthma exacerbation: The patient's symptoms of shortness of breath, coughing up yellow phlegm, and asthma flare-up are consistent with an asthma exacerbation, especially given her history of asthma and recent lack of maintenance medication.
- Other Likely diagnoses
- Allergic rhinitis: The patient's allergy-like symptoms, such as congestion and cough, could be indicative of allergic rhinitis, which is a common comorbidity with asthma.
- Chronic obstructive pulmonary disease (COPD) exacerbation: Although less likely, the patient's symptoms of shortness of breath and coughing up yellow phlegm could also be consistent with a COPD exacerbation, especially if she has a history of smoking or other risk factors.
- Pneumonia: The patient's coughing up yellow phlegm and shortness of breath could be indicative of pneumonia, especially if she has a fever or other systemic symptoms.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Pneumothorax: Although unlikely, a pneumothorax could cause shortness of breath and cough, and would be a medical emergency.
- Pulmonary embolism: A pulmonary embolism could also cause shortness of breath and cough, and would be a life-threatening condition.
- Cardiac asthma (heart failure): The patient's shortness of breath, especially when lying down, could be indicative of heart failure, which would require prompt evaluation and treatment.
- Rare diagnoses
- Cystic fibrosis: Although rare, cystic fibrosis could cause chronic respiratory symptoms, including coughing up yellow phlegm, and would require specific testing and treatment.
- Bronchiectasis: This rare condition could cause chronic respiratory symptoms, including coughing up yellow phlegm, and would require specific testing and treatment.
Each of these diagnoses should be considered and evaluated based on the patient's history, physical examination, and diagnostic testing.