Differential Diagnosis for 48-year-old Female with Respiratory Symptoms
- Single most likely diagnosis
- Viral upper respiratory tract infection (URTI): This is the most likely diagnosis given the patient's symptoms of nasal congestion, rhinorrhea, cough, and a scratchy sore throat, which are typical of a viral infection. The progression of symptoms over 5 days and the change in nasal drainage from clear to thick yellow also support this diagnosis. The recent diagnosis of a viral respiratory illness in her husband further increases the likelihood of a viral etiology.
- Other Likely diagnoses
- Bacterial sinusitis: The patient's symptoms of nasal congestion, rhinorrhea, and cough, along with the change in nasal drainage from clear to thick yellow, could also suggest bacterial sinusitis. However, the absence of other symptoms such as facial pain or headache makes this diagnosis less likely.
- Acute bronchitis: The patient's cough and recent history of a scratchy sore throat could also suggest acute bronchitis, which is often caused by a viral infection.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Influenza: Although the patient's symptoms are not specific for influenza, it is essential to consider this diagnosis, especially during flu season, as it can be severe and even life-threatening in certain populations.
- Pneumonia: The patient's cough and potential fever could also suggest pneumonia, which is a more severe infection that requires prompt diagnosis and treatment.
- Tuberculosis (TB): Although less likely, TB is a critical diagnosis to consider, especially if the patient has been exposed to someone with TB or has a history of immunocompromisation.
- Rare diagnoses
- Allergic fungal sinusitis: This rare condition could present with similar symptoms, including nasal congestion and thick yellow nasal drainage, but is less likely given the patient's denial of seasonal allergies.
- Wegener's granulomatosis: This rare autoimmune disorder can cause respiratory symptoms, including sinusitis and cough, but is unlikely given the patient's lack of other systemic symptoms.