Differential Diagnosis for Cough of 3 Weeks
Single Most Likely Diagnosis
- Acute Bronchitis: This is often the most common cause of a cough lasting for a few weeks. It's usually caused by a viral infection and can be accompanied by other symptoms like runny nose, sore throat, and fatigue. The cough can persist even after the initial infection has resolved.
Other Likely Diagnoses
- Postnasal Drip (Upper Airway Secretion Syndrome): This condition occurs when excess mucus from the nose drips down the back of the throat, triggering a cough. It can be due to allergies, a cold, or sinus infections.
- Asthma: Cough can be a primary symptom of asthma, especially if it's exercise-induced or worsens at night. Other symptoms might include wheezing, shortness of breath, and chest tightness.
- Gastroesophageal Reflux Disease (GERD): Stomach acid can flow up into the esophagus and irritate the throat, leading to a chronic cough. Symptoms can include heartburn, regurgitation, and difficulty swallowing.
- Chronic Obstructive Pulmonary Disease (COPD): While more common in smokers, COPD can cause a persistent cough, often with sputum production. Other symptoms include shortness of breath and wheezing.
Do Not Miss Diagnoses
- Pneumonia: Although less likely if the patient appears well, pneumonia can present with a cough and may not always have fever or severe symptoms, especially in the early stages or in older adults.
- Lung Cancer: A persistent cough, especially if it's new, worsening, or accompanied by other symptoms like weight loss, hemoptysis, or unexplained fatigue, requires investigation for lung cancer, particularly in smokers or those with a significant smoking history.
- Tuberculosis (TB): A chronic cough, especially with systemic symptoms like fever, night sweats, and weight loss, should prompt consideration of TB, especially in individuals from endemic areas or with risk factors like immunosuppression.
- Pulmonary Embolism: While typically presenting acutely, a chronic cough could be a symptom of a chronic pulmonary embolism, especially if accompanied by dyspnea or chest pain.
Rare Diagnoses
- Cystic Fibrosis: More commonly diagnosed in childhood, but can present in adults with a chronic cough, recurrent lung infections, and malabsorption.
- Sarcoidosis: An autoimmune disease that can cause a cough, along with other symptoms like shortness of breath, chest pain, and skin or eye symptoms.
- Eosinophilic Pneumonia: A rare condition characterized by a cough, fever, and shortness of breath, often related to an allergic reaction or certain medications.
- Bronchiectasis: A condition where parts of the airways are damaged, leading to a chronic cough with sputum production, often accompanied by recurrent infections.