Differential Diagnosis

The patient presents with a persistent cough, throat burning sensation, and a history of recent upper respiratory infections. The following differential diagnoses are considered:

• Single most likely diagnosis
  • Acute Bronchitis: The patient's symptoms of persistent cough, throat burning sensation, and recent upper respiratory infection are consistent with acute bronchitis. The presence of crackles on respiratory examination and the absence of fever or shortness of breath also support this diagnosis.
• Other Likely diagnoses
  • Chronic Obstructive Pulmonary Disease (COPD) Exacerbation: The patient's history of smoking and persistent cough suggest COPD, and the recent upper respiratory infection could have triggered an exacerbation.
  • Gastroesophageal Reflux Disease (GERD): The patient's symptoms of throat burning sensation and persistent cough could be related to GERD, especially given the patient's history of recent gastroscopy and upcoming endoscopy.
  • Postnasal Drip: The patient's complaint of a "piece of sugar stuck" in the throat and persistent cough could be related to postnasal drip, which is a common cause of chronic cough.
• Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
  • Pneumonia: Although the patient does not have fever or shortness of breath, pneumonia is a potentially life-threatening condition that must be considered, especially in an elderly patient with a history of cardiovascular disease.
  • Pulmonary Embolism: The patient's history of atrial fibrillation and recent immobility (due to shingles) increase the risk of pulmonary embolism, which can present with persistent cough and chest pain.
  • Lung Cancer: The patient's history of smoking and persistent cough raise the possibility of lung cancer, which must be considered and ruled out with further evaluation.
• Rare diagnoses
  • Pertussis: Although the patient has been vaccinated against pertussis, it is still possible, especially in an elderly patient with a persistent cough.
  • Tuberculosis: The patient's symptoms of persistent cough and recent upper respiratory infection could be related to tuberculosis, although this is less likely given the patient's lack of exposure history and negative symptoms.