Differential Diagnosis for Wheezing and Respiratory Symptoms
Single Most Likely Diagnosis
- Asthma exacerbation: The patient's increased use of albuterol inhaler, wheezing, and cough productive of green sputum are classic symptoms of an asthma exacerbation. The absence of fever and the presence of mild sore throat and headache also fit within the spectrum of asthma exacerbation, possibly triggered by a viral upper respiratory infection.
Other Likely Diagnoses
- Chronic Obstructive Pulmonary Disease (COPD) exacerbation: Similar to asthma, COPD exacerbation can present with increased wheezing, cough productive of colored sputum, and shortness of breath. The lack of fever does not rule out COPD exacerbation, especially if triggered by air pollution or a viral infection.
- Acute Bronchitis: This condition often presents with a cough productive of colored sputum, wheezing, and congestion. While typically viral, the absence of fever does not exclude acute bronchitis, especially if the patient is seen later in the course of the illness.
- Upper Respiratory Infection (URI) with reactive airway disease: A URI can trigger wheezing and cough in individuals with reactive airway disease, not necessarily asthma. The presence of a mild sore throat and headache supports this diagnosis.
Do Not Miss Diagnoses
- Pneumonia: Although the patient does not have a fever, pneumonia can present atypically, especially in older adults or those with compromised immune systems. The presence of green sputum and wheezing could be indicative of a bacterial pneumonia.
- Pulmonary Embolism: While less likely given the symptoms, pulmonary embolism can cause sudden onset of wheezing and shortness of breath. The absence of chest pain or fever does not rule out this diagnosis.
- Foreign Body Aspiration: This is more common in children but can occur in adults, especially if there is a history of altered mental status or dysphagia. It can cause sudden onset of wheezing and cough.
Rare Diagnoses
- Allergic Bronchopulmonary Aspergillosis (ABPA): This condition occurs in asthmatic patients and can cause worsening of asthma symptoms, including wheezing and cough productive of plugs or green sputum.
- Cystic Fibrosis: Typically diagnosed in childhood, but mild forms may present later in life with recurrent respiratory infections, wheezing, and productive cough.
- Bronchiolitis Obliterans: A rare condition that can cause obstructive lung disease symptoms, including wheezing and cough, often following a respiratory infection or inhalational injury.