Differential Diagnosis for 66 year old female with worsening URI
- Single most likely diagnosis
- Acute bronchitis or exacerbation of chronic bronchitis: Given the patient's history of pulmonary hypertension and recent pneumonia, it's likely that her current symptoms are related to a respiratory infection. The fact that she completed doxycycline 1 month prior suggests that the current illness may be a new infection or a complication of the previous one.
- Other Likely diagnoses
- Pneumonia: Although she completed antibiotics for pneumonia recently, it's possible that she has developed a new pneumonia, especially if she has underlying lung disease or immunocompromised status.
- Pulmonary embolism: Given her history of pulmonary hypertension, she may be at increased risk for pulmonary embolism, which can present with worsening respiratory symptoms.
- Exacerbation of pulmonary hypertension: Worsening symptoms could be related to an exacerbation of her underlying pulmonary hypertension, which may require adjustment of her treatment regimen.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Sepsis: Although less likely, sepsis is a life-threatening condition that requires prompt recognition and treatment. The patient's recent history of pneumonia and current worsening symptoms make it essential to consider sepsis in the differential diagnosis.
- Lung cancer: Although rare, lung cancer can present with worsening respiratory symptoms, and it's essential to consider it in the differential diagnosis, especially in a patient with a history of smoking or other risk factors.
- Rare diagnoses
- Cystic fibrosis exacerbation: Although rare in a 66-year-old patient, cystic fibrosis can present with worsening respiratory symptoms, and it's essential to consider it in the differential diagnosis if other causes are ruled out.
- Pulmonary vasculitis: This is a rare condition that can present with worsening respiratory symptoms and pulmonary hypertension. It's essential to consider it in the differential diagnosis if other causes are ruled out and the patient has a history of autoimmune disorders or other risk factors.