Differential Diagnosis for Persistent Cough in Adults
Single Most Likely Diagnosis
- Chronic Obstructive Pulmonary Disease (COPD): This is the most likely diagnosis for a persistent cough in adults, especially those with a history of smoking or exposure to lung irritants. COPD is a progressive lung disease characterized by chronic inflammation and airflow limitation.
Other Likely Diagnoses
- Asthma: A common condition that can cause persistent cough, especially at night or with exercise. Asthma is characterized by inflammation and hyperreactivity of the airways.
- Gastroesophageal Reflux Disease (GERD): Stimulation of the vagus nerve by acid reflux can cause a persistent cough. GERD is a common condition where stomach acid flows back into the esophagus.
- Postnasal Drip: Also known as upper airway secretion syndrome, this condition occurs when mucus from the nasal passages drips down the back of the throat, causing a persistent cough.
- Bronchitis: Either acute or chronic bronchitis can cause a persistent cough, often with mucus production.
Do Not Miss Diagnoses
- Lung Cancer: Although less likely, lung cancer can cause a persistent cough, especially if it involves the central airways. It is essential to consider this diagnosis, especially in smokers or those with a family history.
- Tuberculosis (TB): A bacterial infection that can cause a persistent cough, often with weight loss, night sweats, and fever. TB is more common in immunocompromised individuals or those from endemic areas.
- Pneumonia: Bacterial or viral pneumonia can cause a persistent cough, especially if it becomes chronic or recurrent.
- Pulmonary Embolism: A blood clot in the lungs can cause a sudden onset of cough, often with shortness of breath and chest pain.
Rare Diagnoses
- Cystic Fibrosis: A genetic disorder that affects the respiratory and digestive systems, causing persistent cough and mucus production.
- Sarcoidosis: An autoimmune disease that can cause inflammation in the lungs, leading to a persistent cough.
- Interstitial Lung Disease: A group of diseases that affect the lung tissue, causing scarring and inflammation, which can lead to a persistent cough.
- Foreign Body Aspiration: An object lodged in the airways can cause a persistent cough, often with choking or wheezing.