Differential Diagnosis

The patient presents with symptoms of a chest infection, including a productive cough, chest soreness, and sore neck, along with a history of recent respiratory illnesses. The following differential diagnoses are considered:

• Single Most Likely Diagnosis
  • Acute Bronchitis: This is the most likely diagnosis given the patient's symptoms of a productive cough, chest soreness, and recent exposure to others with respiratory illnesses. The patient's improvement with self-management and lack of significant medical history also support this diagnosis.
• Other Likely Diagnoses
  • Upper Respiratory Tract Infection (URTI): The patient's symptoms of a sore neck, lost voice, and sinus pain could also be indicative of a URTI, which is common in individuals with recent exposure to others with respiratory illnesses.
  • Viral Pharyngitis: The patient's red and swollen tonsils, along with a sore throat, could suggest a viral pharyngitis, which is also common in this population.
  • Recurrent Acute Respiratory Infections: The patient's recent history of multiple respiratory infections could suggest an underlying issue with their immune system or exposure to infectious agents.
• Do Not Miss Diagnoses
  • Pneumonia: Although the patient's symptoms and physical examination do not strongly suggest pneumonia, it is a potentially life-threatening condition that must be considered, especially in individuals with recent respiratory illnesses.
  • Influenza: Despite the patient's recent negative influenza test, the diagnosis of influenza should still be considered, especially given the patient's sister currently has the flu.
  • Tuberculosis (TB): Although less likely, TB should be considered in individuals with recurrent respiratory infections, especially if they have been exposed to others with TB.
• Rare Diagnoses
  • Bronchiectasis: This is a rare condition characterized by permanent dilation of the bronchi, which could lead to recurrent respiratory infections.
  • Immunodeficiency: A rare underlying immunodeficiency could be contributing to the patient's recurrent infections, although there is no significant medical history to suggest this.
  • Lung Cancer: Although extremely rare in this age group, lung cancer could present with recurrent respiratory infections, although other symptoms such as weight loss and hemoptysis would be expected.