Differential Diagnosis for Dry Persistent Cough

Single Most Likely Diagnosis

• Asthma: A common condition characterized by chronic inflammation of the airways, leading to episodes of wheezing, breathlessness, chest tightness, and coughing. A dry, persistent cough is a hallmark symptom, especially if it worsens at night or with exercise.

Other Likely Diagnoses

• Gastroesophageal Reflux Disease (GERD): Stomach acid reflux can irritate the throat and lungs, causing a persistent dry cough. This is often worse after eating or at night.
• Chronic Obstructive Pulmonary Disease (COPD): Includes conditions like emphysema and chronic bronchitis, characterized by a long-term cough, often producing mucus, but can be dry in early stages.
• Allergic Rhinitis: Postnasal drip from allergies can trigger a dry cough, especially if the individual has a sensitivity to dust, pollen, or other environmental allergens.
• Inhalation of Irritants: Exposure to smoke, dust, or chemicals at work or in the environment can cause a persistent dry cough.

Do Not Miss Diagnoses

• Lung Cancer: Although less common, a persistent cough can be an early sign of lung cancer, especially in smokers or those exposed to carcinogens.
• Tuberculosis (TB): A bacterial infection that primarily affects the lungs and can cause a chronic cough, which may initially be dry.
• Pneumonia: Certain types of pneumonia can present with a dry cough, especially in the early stages or in specific populations like the elderly.
• Pulmonary Embolism: While more commonly associated with sudden onset of shortness of breath, a persistent dry cough can occasionally be a symptom, especially if smaller emboli are present.

Rare Diagnoses

• Sarcoidosis: An autoimmune disease that can affect multiple parts of the body, including the lungs, leading to a dry cough among other symptoms.
• Cystic Fibrosis: A genetic disorder that leads to the production of thick, sticky mucus, but can initially present with a dry cough in some cases.
• Eosinophilic Pneumonia: A rare condition characterized by an accumulation of eosinophils in the lungs, which can cause a dry cough.
• Bronchiectasis: A condition where parts of the airways are permanently enlarged, leading to chronic cough, which may be dry, especially in early stages.