Differential Diagnosis for Toux en Retour de Voyage (Cough After Travel)
Single Most Likely Diagnosis
- Acute Bronchitis: This is often the most common cause of a cough after travel, typically resulting from a viral upper respiratory infection that may have been contracted during travel due to exposure to new pathogens or environments.
Other Likely Diagnoses
- Influenza: Travel increases the risk of exposure to influenza, especially during peak seasons, leading to symptoms including cough.
- Common Cold: Similar to acute bronchitis, the common cold is a frequent cause of cough and can be easily contracted during travel.
- Allergic Rhinitis: Exposure to new allergens during travel can trigger allergic reactions, leading to cough among other symptoms.
- Pneumonia: While less common, pneumonia is a significant consideration, especially if the cough is severe, accompanied by fever, or if the patient has underlying health conditions.
Do Not Miss Diagnoses
- Tuberculosis (TB): Although less common in many parts of the world, TB is a critical diagnosis not to miss, especially if the patient has traveled to areas with high TB prevalence or has been exposed to someone with TB.
- Malaria: If the travel involved areas where malaria is endemic, and the patient presents with cough along with fever, chills, or flu-like symptoms, malaria must be considered.
- Pulmonary Embolism: Long-distance travel increases the risk of deep vein thrombosis and pulmonary embolism, which can present with sudden onset of cough among other symptoms.
- COVID-19: Given its global spread and the fact that travel can increase exposure risk, COVID-19 should be considered, especially if the patient has been in crowded areas or had close contact with someone infected.
Rare Diagnoses
- Histoplasmosis: For travelers who have spent time in caves, bird roosts, or disturbed soil in endemic areas, histoplasmosis is a rare but possible cause of cough.
- Coccidioidomycosis: Travel to the southwestern United States or other endemic areas could result in exposure to this fungal infection, which can cause cough among other symptoms.
- SARS or Other Emerging Infectious Diseases: While rare, travel history to areas with outbreaks of emerging infectious diseases necessitates consideration of these diagnoses, especially if the patient presents with severe or atypical symptoms.