Differential Diagnosis for Chronic Cough in a Middle-Aged Man
Single Most Likely Diagnosis
- Gastroesophageal Reflux Disease (GERD): This is often considered the most common cause of chronic cough in adults, especially in the absence of other symptoms. GERD can cause stomach acid to flow up into the throat, irritating the lungs and triggering a cough.
Other Likely Diagnoses
- Asthma: A common condition that can cause chronic cough, often accompanied by wheezing and shortness of breath. Asthma can be allergic or non-allergic in nature.
- Chronic Obstructive Pulmonary Disease (COPD): Includes conditions like emphysema and chronic bronchitis, which can cause a chronic cough, often productive of mucus.
- Postnasal Drip (Upper Airway Secretion Syndrome): Excess mucus from the nose can drip down the back of the throat, triggering a cough.
- Allergic Rhinitis: Similar to postnasal drip, allergies can cause increased mucus production, leading to a chronic cough.
Do Not Miss Diagnoses
- Lung Cancer: Although less common, lung cancer can present with a chronic cough as an early symptom. It's crucial to investigate further, especially in smokers or those with a significant smoking history.
- Tuberculosis (TB): A chronic cough can be a symptom of TB, especially if accompanied by weight loss, fever, or night sweats. TB is less common in some regions but is a critical diagnosis not to miss due to its infectious nature and the availability of treatment.
- Pulmonary Embolism: While typically presenting acutely, in some cases, a pulmonary embolism can cause a chronic cough, especially if smaller, recurrent emboli occur.
Rare Diagnoses
- Sarcoidosis: An autoimmune disease that can affect the lungs, causing a chronic cough among other symptoms like shortness of breath and chest pain.
- Cystic Fibrosis: Although more commonly diagnosed in childhood, some cases of cystic fibrosis may not be diagnosed until adulthood, presenting with a chronic cough and other respiratory symptoms.
- Bronchiectasis: A condition characterized by damaged airways, leading to a chronic cough and recurrent infections.
- Eosinophilic Granuloma with Polyangiitis (Churg-Strauss Syndrome): A rare autoimmune condition that can cause a chronic cough, asthma, and other systemic symptoms.