Differential Diagnosis
- Single most likely diagnosis
- Pneumothorax: The patient's chest X-ray shows a clear pneumothorax in the left lung, which is a direct indicator of this condition. The presence of shortness of breath (SOB) also supports this diagnosis, as pneumothorax can cause respiratory distress.
- Other Likely diagnoses
- Asthma exacerbation: The patient is already on albuterol and fluticasone inhalers for asthma and presents with bilateral basilar wheezes, which are common findings in asthma exacerbations. The symptoms of SOB could also be attributed to an asthma exacerbation, especially given the patient's history.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Tension Pneumothorax: Although the chest X-ray shows a clear pneumothorax, it's crucial not to miss the possibility of a tension pneumothorax, which is a life-threatening condition. Symptoms can include severe respiratory distress, decreased breath sounds on the affected side, and potentially signs of cardiac compromise.
- Rare diagnoses
- Viral URTI (Upper Respiratory Tract Infection): While a viral URTI could potentially cause SOB and wheezing, especially if it triggers an asthma exacerbation, the presence of a clear pneumothorax on the chest X-ray makes this a less likely primary diagnosis. However, it could be a contributing factor to the patient's condition, especially if the URTI triggered an asthma exacerbation that led to the pneumothorax.