Differential Diagnosis for Elevated Monocytes and Neutrophils with Right CVA Pain and Productive Cough
- Single Most Likely Diagnosis
- Pneumonia: This is the most likely diagnosis given the combination of elevated monocytes and neutrophils (indicating a bacterial infection), right costovertebral angle (CVA) pain (suggesting possible involvement of the lower lobes of the lung), and a productive cough (common in pneumonia). The right CVA pain could also be related to referred pain from the diaphragm due to a lower lobe pneumonia.
- Other Likely Diagnoses
- Pulmonary Embolism: Although less likely than pneumonia, pulmonary embolism could present with sudden onset of chest pain and cough. The elevation in monocytes and neutrophils might not be as pronounced but could occur, especially if there's associated pneumonia or infarction.
- Acute Bronchitis: This condition could also present with a productive cough and elevated white blood cell count, including monocytes and neutrophils, especially if it's caused by a bacterial infection.
- Do Not Miss Diagnoses
- Lung Abscess: A lung abscess could present with similar symptoms, including productive cough and chest pain, and would require prompt diagnosis and treatment to avoid serious complications.
- Empyema: An empyema, which is a collection of pus in the pleural space, could cause chest pain, fever, and a productive cough. It's a serious condition that requires drainage and antibiotic therapy.
- Sepsis: If the infection is severe and has entered the bloodstream, sepsis could be a life-threatening condition that needs immediate recognition and treatment.
- Rare Diagnoses
- Actinomycosis: A rare bacterial infection that can cause chronic chest pain, cough, and weight loss. It might present with an elevated white blood cell count, including monocytes and neutrophils.
- Histoplasmosis: A fungal infection that can cause lung symptoms similar to pneumonia, including cough and chest pain, and might elevate monocytes and neutrophils, especially in immunocompromised patients.