Differential Diagnosis for Night Cough
Single Most Likely Diagnosis
- Asthma: A common condition that often presents with cough, particularly at night, due to the natural circadian rhythm of cortisol and the increased exposure to allergens and irritants in the evening.
Other Likely Diagnoses
- Gastroesophageal Reflux Disease (GERD): Stomach acid reflux can trigger coughing, especially when lying down at night, making it a common cause of nocturnal cough.
- Upper Respiratory Tract Infections: Viral infections such as the common cold or flu can cause cough, which may worsen at night due to increased mucus production and postnasal drip.
- Allergic Rhinitis: Similar to asthma, allergies can cause cough, especially at night, due to increased exposure to allergens like dust mites in bedding.
Do Not Miss Diagnoses
- Pneumonia: Although less common, pneumonia can present with cough and may worsen at night; missing this diagnosis could lead to severe consequences, including sepsis and death.
- Pulmonary Embolism: A life-threatening condition that can cause sudden onset of cough, among other symptoms; it's crucial to consider this in patients with risk factors such as recent travel, surgery, or family history of clotting disorders.
- Heart Failure: Congestive heart failure can lead to nocturnal cough due to pulmonary congestion; recognizing this condition is vital to prevent further cardiac deterioration.
Rare Diagnoses
- Cystic Fibrosis: A genetic disorder leading to persistent lung infections and cough; although rare, it should be considered in patients with a family history or other suggestive symptoms like malabsorption.
- Interstitial Lung Disease: A group of disorders affecting the lung tissue, which can cause chronic cough; these conditions are less common but important to diagnose for appropriate management.
- Tuberculosis: A bacterial infection that can cause chronic cough, among other symptoms; while rare in some populations, it remains a significant concern globally and should be considered based on exposure history and risk factors.