Differential Diagnosis for 76-year-old Female with Cough and Sore Throat
Single Most Likely Diagnosis
- Influenza or Common Cold: Given the symptoms of cough and sore throat, and considering the exposure to mouse feces is not directly linked to a specific disease that causes these symptoms, a viral upper respiratory infection is the most likely diagnosis. The exposure to mouse feces might suggest other diagnoses, but the symptoms provided do not strongly point towards a specific zoonotic disease without additional symptoms like fever, rash, or severe respiratory distress.
Other Likely Diagnoses
- Allergic Rhinitis: Exposure to mouse feces could potentially trigger allergic reactions, leading to symptoms like cough and sore throat, especially if the patient has pre-existing allergies.
- Sinusitis: Secondary bacterial sinusitis could develop following a viral upper respiratory infection, especially in an elderly patient, leading to persistent cough and sore throat.
- Bronchitis: Either acute or chronic bronchitis could present with cough and might be considered, especially if the patient has a history of smoking or chronic obstructive pulmonary disease (COPD).
Do Not Miss Diagnoses
- Hantavirus: Although less likely, given the exposure to mouse feces, hantavirus infection is a critical diagnosis not to miss. It can cause hantavirus pulmonary syndrome (HPS), which has a high mortality rate. Early symptoms can be non-specific, including fever, fatigue, and muscle aches, but can rapidly progress to severe respiratory distress.
- Leptospirosis: This bacterial infection, transmitted through the urine of infected animals (including rodents), can cause a range of symptoms from mild (fever, headache, muscle aches) to severe (meningitis, kidney or liver failure). The initial phase might resemble a common cold or flu.
- Lymphocytic Choriomeningitis (LCMV): Another viral infection carried by rodents, LCMV can cause symptoms ranging from mild (fever, headache, muscle aches) to severe (meningitis, encephalitis). It's particularly concerning in immunocompromised individuals.
Rare Diagnoses
- Tularemia: Caused by the bacterium Francisella tularensis, tularemia can be transmitted through contact with infected animal tissues or vectors like ticks. Symptoms can include fever, chills, and sore throat, but it's relatively rare and usually associated with more specific exposures (e.g., hunting, gardening).
- Plague: While extremely rare in most areas, plague (caused by Yersinia pestis) can be transmitted through the bites of infected fleas, direct contact with infected animals, or occasionally by inhalation. Symptoms depend on the form of the disease (bubonic, septicemic, pneumonic) but can include fever, chills, and cough in the pneumonic form.