Medical Advisory BoardAll articles are reviewed for accuracy by our Medical Advisory Board
Educational purpose only • Exercise caution as content is pending human review
Article Review Status
Submitted
Under Review
Approved

Last updated: September 25, 2025 • View editorial policy

Personalize

Help us tailor your experience

Which best describes you? Your choice helps us use language that's most understandable for you.

Differential Diagnosis for 81-year-old Male with SOB, Neutrophilia, and Elevated CRP

Single Most Likely Diagnosis

  • Pneumonia: Given the patient's symptoms of shortness of breath (SOB), neutrophilia, and significantly elevated CRP (81), pneumonia is a highly plausible diagnosis. The patient's age and history of heart failure with reduced ejection fraction (HFrEF) increase his susceptibility to pneumonia.

Other Likely Diagnoses

  • Acute Exacerbation of Heart Failure (AEHF): The patient's history of HFrEF and current symptoms of SOB could indicate an exacerbation of heart failure, potentially triggered by an acute event such as pneumonia or myocardial infarction.
  • Acute Coronary Syndrome (ACS): Although the patient has a history of non-ST-elevation myocardial infarction (NSTEMI) and coronary artery disease (CAD), new or worsening symptoms could indicate another acute coronary event.
  • Sepsis: The presence of neutrophilia and a high CRP level, in combination with SOB, could suggest sepsis, particularly if there is a suspected source of infection.

Do Not Miss Diagnoses

  • Pulmonary Embolism (PE): This is a critical diagnosis to consider in any patient with acute onset of SOB, especially in the context of recent immobilization or other risk factors for thromboembolism. Although less likely than pneumonia given the neutrophilia and CRP elevation, missing a PE could be fatal.
  • Cardiac Tamponade: Although less common, cardiac tamponade can present with SOB and could be a complication of the patient's cardiac history. It requires immediate recognition and treatment.
  • Aortic Dissection: Given the patient's history of hypertension (often associated with CAD and HFrEF), aortic dissection is a life-threatening condition that must be considered, especially if there are symptoms such as chest or back pain.

Rare Diagnoses

  • Pulmonary Vasculitis: Conditions like Wegener's granulomatosis or other forms of vasculitis could present with SOB, neutrophilia, and elevated inflammatory markers, although they are much less common.
  • Lymphangitic Carcinomatosis: Metastatic cancer to the lungs can cause SOB and could potentially lead to elevated inflammatory markers, although this would be less likely without a known history of cancer.

Related Questions

What is the recommended surgical technique for removing a plate from the distal third of the fibula in an ankle fracture?
What QTc interval is too prolonged for the use of Zofran (ondansetron)?
What is a femoral-femoral (fem-fem) bypass?
When is Rabies Post-Exposure Prophylaxis (PEP) indicated for a dog bite in Utah?
How to titrate intravenous (IV) nitroglycerine for blood pressure control?

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

Have a follow-up question?

Our Medical A.I. is used by practicing medical doctors at top research institutions around the world. Ask any follow up question and get world-class guideline-backed answers instantly.

Ask Question