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.)
- Lung cancer: Although less likely, lung cancer can present with worsening respiratory symptoms, and it's essential to consider this diagnosis, especially in a patient with a history of smoking or other risk factors.
- Tuberculosis: TB can present with chronic respiratory symptoms, and it's crucial to consider this diagnosis, especially if the patient has been exposed to someone with TB or has a history of immunocompromised status.
- Sepsis: If the patient's symptoms are severe or worsening rapidly, sepsis should be considered, especially if she has a history of immunocompromised status or underlying medical conditions.
- Rare diagnoses
- Cystic fibrosis: Although rare in a 66-year-old patient, cystic fibrosis can present with chronic respiratory symptoms, and it's essential to consider this diagnosis if other explanations are not found.
- Sarcoidosis: This rare disease can present with respiratory symptoms, and it's crucial to consider this diagnosis if other explanations are not found, especially if the patient has a history of autoimmune disorders or other systemic symptoms.