Differential Diagnosis for Cough with Pleuritic Chest Pain

• Single most likely diagnosis:
  • Pneumonia: This is often the first consideration for cough with pleuritic chest pain due to its high prevalence and the fact that it can cause both symptoms. Pleuritic chest pain is a sharp pain that worsens with breathing, which is consistent with an infection like pneumonia that can inflame the pleura.
• Other Likely diagnoses:
  • Pulmonary Embolism (PE): Although less common than pneumonia, PE is a significant cause of pleuritic chest pain and can be accompanied by cough. It's a critical diagnosis to consider, especially in patients with risk factors for thromboembolism.
  • Acute Bronchitis: This condition can cause cough and, if severe, might lead to pleuritic chest pain due to inflammation of the airways and possibly the pleura.
  • Influenza: Especially during flu season, influenza can cause both cough and pleuritic chest pain, particularly if there is an associated pneumonia.
• Do Not Miss diagnoses:
  • Pneumothorax: A collapsed lung can cause sudden, severe pleuritic chest pain and cough. It's less common but critical to diagnose promptly because it can be life-threatening.
  • Tuberculosis (TB): Although less common in some regions, TB can cause chronic cough and pleuritic chest pain, especially in individuals with risk factors such as immunocompromised states or exposure history.
  • Lung Cancer: While less likely to present acutely, lung cancer can cause cough and pleuritic chest pain, especially if the tumor involves the pleura.
• Rare diagnoses:
  • Pulmonary Vasculitis (e.g., Wegener's granulomatosis): These are autoimmune conditions that can cause inflammation of the blood vessels in the lungs, leading to cough and pleuritic chest pain.
  • Sarcoidosis: An autoimmune disease that can affect the lungs, causing cough and chest pain, although it more commonly presents with systemic symptoms.
  • Eosinophilic Pneumonia: A rare condition characterized by an accumulation of eosinophils in the lungs, which can cause cough, fever, and pleuritic chest pain.