Differential Diagnosis for 21yo Female with Cough and Fever
Single Most Likely Diagnosis
- Acute Bronchitis: This is the most likely diagnosis given the symptoms of cough, fever, chest congestion, and lost voice. The negative COVID test and the duration of symptoms (7 days) also support this diagnosis, as acute bronchitis is a common cause of prolonged cough and respiratory symptoms in young adults.
Other Likely Diagnoses
- Influenza: Despite the negative COVID test, influenza is still a possibility, especially during flu season. The symptoms of fever, cough, and lost voice are consistent with influenza.
- Sinusitis: The increased nasal congestion and lost voice could indicate sinusitis, which often presents with respiratory symptoms similar to those described.
- Laryngitis: The lost voice (hoarseness) is a key symptom of laryngitis, which could be caused by a viral infection, consistent with the other symptoms.
Do Not Miss Diagnoses
- Pneumonia: Although less likely given the overall clinical picture, pneumonia is a potentially life-threatening condition that must be considered, especially if the patient has risk factors such as underlying health conditions or if symptoms worsen.
- Pertussis (Whooping Cough): This bacterial infection can cause severe coughing fits and is a critical diagnosis not to miss, especially in individuals who are not up to date on their vaccinations.
- Tuberculosis (TB): While less common, TB can present with chronic cough and fever. It's essential to consider TB, especially if the patient has been exposed to someone with TB or has risk factors such as immunocompromised status.
Rare Diagnoses
- Sarcoidosis: A rare autoimmune disease that can cause respiratory symptoms, including cough and shortness of breath, but it would be unusual for it to present acutely with fever and lost voice.
- Histoplasmosis: A fungal infection that can cause respiratory symptoms, including cough and fever, but it's more common in specific geographic areas and in individuals with certain exposures (e.g., bird or bat droppings).
- Lemierre's Syndrome: A rare condition characterized by a bacterial infection of the throat, which can lead to respiratory symptoms and sepsis. It's an important diagnosis to consider in young adults with severe pharyngitis and respiratory symptoms.