Differential Diagnosis for Cough Expectoration after Contact with a Child

• Single most likely diagnosis:
  • Pertussis (Whooping Cough): This is a highly contagious respiratory illness caused by Bordetella pertussis. It's particularly concerning in households with infants, as it can be severe in young children. The fact that symptoms appeared after contact with the child suggests a possible transmission, making pertussis a prime consideration.
• Other Likely diagnoses:
  • Influenza: This is another highly contagious respiratory virus that can spread quickly within households. Symptoms can range from mild to severe and include cough, fever, and body aches.
  • Common Cold: Caused by various viruses, the common cold is very contagious and can spread through close contact with an infected person. Symptoms include cough, sneezing, runny nose, and sore throat.
  • Respiratory Syncytial Virus (RSV) Infection: RSV is a common virus that affects all ages but is most severe in young children and older adults. It can cause symptoms ranging from mild cold-like symptoms to severe lower respiratory infections like bronchiolitis and pneumonia.
• Do Not Miss (ddxs that may not be likely, but would be deadly if missed.):
  • Tuberculosis (TB): Although less common in many parts of the world, TB is a serious infection that can be spread through the air when an infected person coughs, sneezes, or talks. It's crucial to consider TB, especially if the child or other family members have recently traveled to or from areas with high TB prevalence or if they are immunocompromised.
  • Pneumonia: Bacterial pneumonia, such as that caused by Streptococcus pneumoniae, can be severe and requires prompt antibiotic treatment. It's essential to consider pneumonia, especially if the patient has a high fever, difficulty breathing, or other severe symptoms.
• Rare diagnoses:
  • Adenovirus Infection: While common in children, adenovirus can cause a range of illnesses, from common cold symptoms to more severe conditions like pneumonia or bronchitis, especially in adults or those with compromised immune systems.
  • Mycoplasma pneumoniae Infection: This bacterium causes a type of pneumonia known as "walking pneumonia," which can present with mild symptoms but may lead to more severe complications if not treated properly. It's more common in school-aged children but can affect adults as well.