Differential Diagnosis for 41-year-old Female with Worsening Cough
- Single most likely diagnosis:
- Acute Bronchitis: This is the most likely diagnosis given the patient's symptoms of a worsening cough, initial sore throat and nasal congestion, and a dry, painful cough with a burning sensation in the chest. The patient's history of smoking also increases her risk for bronchitis.
- Other Likely diagnoses:
- Upper Respiratory Infection (URI): The patient's initial symptoms of sore throat and nasal congestion suggest a URI, which could have progressed to include cough and shortness of breath.
- Asthma: The patient's symptoms of cough, shortness of breath with exertion, and a burning sensation in the chest could be indicative of asthma, especially if she has a history of asthma or other respiratory conditions.
- Pneumonia: Although the patient does not have a current fever, she reports a questionable subjective fever, and pneumonia is a possible diagnosis to consider, especially given her symptoms of cough and shortness of breath.
- Do Not Miss diagnoses:
- Pulmonary Embolism (PE): Although less likely, PE is a potentially life-threatening condition that must be considered, especially if the patient has risk factors such as a history of smoking or recent immobility.
- Cardiac Conditions (e.g., heart failure, myocardial infarction): The patient's symptoms of shortness of breath with exertion and chest pain could be indicative of a cardiac condition, which would require immediate medical attention.
- Rare diagnoses:
- Interstitial Lung Disease: This is a less likely diagnosis, but could be considered if the patient has a history of exposure to certain substances or has other underlying medical conditions.
- Tuberculosis (TB): Although rare, TB is a possible diagnosis to consider, especially if the patient has a history of exposure or has recently traveled to an area where TB is common.