Differential Diagnosis for Basal Infiltrates on Chest CT with Cough
Single Most Likely Diagnosis
- Chronic Bronchitis: This condition is a common cause of basal infiltrates and cough, especially in smokers or those with a history of smoking. The chronic inflammation of the bronchial tubes leads to persistent cough and can cause infiltrates visible on a chest CT.
Other Likely Diagnoses
- Pneumonia: Community-acquired pneumonia can present with basal infiltrates and cough. The presence of fever, sputum production, and shortness of breath can support this diagnosis.
- Asthma: Severe asthma can cause airway inflammation that may appear as basal infiltrates on a chest CT, accompanied by a chronic cough.
- Interstitial Lung Disease (ILD): Conditions like idiopathic pulmonary fibrosis (IPF) can present with basal infiltrates and a dry cough. ILDs are a group of disorders that affect the interstitium of the lung.
- Bronchiectasis: This condition involves permanent enlargement of parts of the airways and can cause chronic cough and basal infiltrates due to recurrent infections.
Do Not Miss Diagnoses
- Lung Cancer: Although less common, lung cancer can present with basal infiltrates and a persistent cough. It's crucial to consider this diagnosis, especially in smokers or those with a significant smoking history.
- Tuberculosis (TB): TB can cause basal infiltrates and cough, and it's essential to consider this diagnosis, particularly in individuals from endemic areas or with risk factors for TB exposure.
- Pulmonary Embolism: While typically presenting with acute symptoms, chronic pulmonary embolism can cause basal infiltrates and cough. This diagnosis is critical to consider due to its high mortality rate if untreated.
Rare Diagnoses
- Lymphangitic Carcinomatosis: A rare condition where cancer spreads to the lymphatic vessels of the lung, causing basal infiltrates and cough.
- Eosinophilic Pneumonia: A rare condition characterized by an accumulation of eosinophils in the lungs, which can present with basal infiltrates and cough.
- Cryptogenic Organizing Pneumonia (COP): A rare condition that can cause basal infiltrates and cough, characterized by the presence of organizing pneumonia on histopathology without an identifiable cause.