History of Present Illness (HPI)

The patient presents with a 5-day history of persistent cough, chest tightness, and pressure pain that worsens with coughing, accompanied by shortness of breath (SOB), wheezing, sinus congestion, rhinorrhea (RN), sore throat (ST), swollen glands, headache (HA), numbness/tingling, weakness, fever, chills, body aches (BA), and nausea/vomiting (N/V). The symptoms have gradually progressed. The patient denies any abdominal pain but reports vomiting due to persistent coughing and drainage. Recent travel and lack of sleep are also noted.

Differential Diagnosis

• Single Most Likely Diagnosis
  • Acute Bronchitis or Viral Respiratory Infection: Given the combination of cough, chest tightness, SOB, wheezing, and the gradual progression of symptoms, an acute viral respiratory infection or acute bronchitis is highly plausible. The presence of systemic symptoms like fever, chills, and body aches further supports this diagnosis.
• Other Likely Diagnoses
  • Influenza: The symptoms of fever, chills, body aches, cough, and SOB, especially during a time when the patient has been traveling and possibly exposed to various pathogens, make influenza a likely consideration.
  • Pneumonia: Although the patient does not report any abdominal pain, the presence of cough, chest tightness, fever, and chills could indicate pneumonia, especially if the cough is productive or if there are signs of consolidation on physical examination.
  • Sinusitis: Given the sinus congestion, rhinorrhea, and sore throat, sinusitis could be a contributing factor to the patient's symptoms, possibly as a primary diagnosis or complicating another condition.
• Do Not Miss Diagnoses
  • Pulmonary Embolism (PE): Although less likely given the gradual progression of symptoms, PE is a critical diagnosis not to miss due to its high mortality rate. The presence of chest pain and shortness of breath, even without typical risk factors, warrants consideration.
  • Tuberculosis (TB): Given the patient's recent travel, TB could be a consideration, especially if the patient has been exposed to someone with TB or has traveled to an area with high TB prevalence.
  • COVID-19: Depending on the current epidemiological context and the patient's travel history, COVID-19 should be considered due to its potential for severe respiratory illness and the broad range of symptoms it can cause.
• Rare Diagnoses
  • Sarcoidosis: This condition can present with cough, shortness of breath, and systemic symptoms like fever and weakness, although it is less common and typically has a more chronic course.
  • Lymphoma: Given the swollen glands and systemic symptoms, although rare, lymphoma could be considered, especially if the patient's symptoms do not resolve with typical treatments for viral or bacterial infections.