Asthma Exacerbation: This is the most likely diagnosis given the presentation of asthma symptoms worsening, which can be triggered by a variety of factors including upper respiratory infections (URIs), allergens, or air pollutants. The presence of wheezing, shortness of breath, and cough, especially if they are familiar symptoms to the patient, supports this diagnosis.

Upper Respiratory Infection (URI): URIs are common and can trigger asthma exacerbations. Symptoms such as runny nose, sore throat, and cough can overlap with asthma symptoms, making it a likely consideration in the differential diagnosis.
Pneumonia (PNA): Community-acquired pneumonia can present with symptoms similar to those of an asthma exacerbation, especially if the pneumonia is caused by an atypical bacterium. The presence of fever, productive cough, and shortness of breath could suggest pneumonia.

Pneumothorax: Although less common, pneumothorax can occur in the setting of severe asthma exacerbation or as a complication of pneumonia. It is critical to consider this diagnosis due to its potential for severe consequences if missed.
Status Asthmaticus: A severe, life-threatening asthma exacerbation that does not respond to standard treatments. Early recognition is crucial for appropriate management.
Influenza or Other Viral Pneumonia: Especially during flu season or in the context of a viral outbreak, these can present similarly to asthma exacerbation or URI but may require specific antiviral treatment.
Bacterial Pneumonia Requiring Hospitalization: Certain types of bacterial pneumonia, such as those caused by Streptococcus pneumoniae, can present with severe symptoms and may require hospitalization for intravenous antibiotics.

Allergic Bronchopulmonary Aspergillosis (ABPA): A rare condition that occurs in people with asthma or cystic fibrosis, characterized by an allergic reaction to Aspergillus fungus. It can cause worsening asthma symptoms.
Churg-Strauss Syndrome: A rare autoimmune condition that can cause asthma, high eosinophil counts, and vasculitis. It is a consideration in patients with new-onset or difficult-to-control asthma.
Cystic Fibrosis: Although typically diagnosed in childhood, some cases may not be diagnosed until adulthood. It can present with recurrent respiratory infections and asthma-like symptoms.