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 the risk for bronchitis.
- Other Likely diagnoses:
- Upper Respiratory Tract Infection (URTI): The patient's symptoms of sore throat, nasal congestion, and cough are consistent with a URTI. The presence of faint upper airway wheezing also supports this diagnosis.
- Asthma: The patient's symptoms of shortness of breath with exertion and faint upper airway wheezing could be indicative of asthma, especially given her occupational exposure to potential respiratory irritants in the OR.
- Pneumonia: Although the patient does not have a current fever, she reports a questionable subjective fever, and her symptoms of cough, shortness of breath, and chest pain could be consistent with pneumonia.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.):
- Pulmonary Embolism (PE): Although less likely, PE is a potentially life-threatening condition that can present with sudden onset of shortness of breath, chest pain, and cough. The patient's history of smoking and potential for immobility during surgical procedures increase her risk for PE.
- Tuberculosis (TB): Given the patient's occupation in the OR, she may be at risk for exposure to TB. Although less likely, TB can present with chronic cough, chest pain, and shortness of breath, making it a "do not miss" diagnosis.
- Rare diagnoses:
- Sarcoidosis: This is a rare condition that can present with cough, shortness of breath, and chest pain. Although unlikely, it could be considered in the differential diagnosis, especially if the patient has other systemic symptoms or a history of exposure to potential triggers.
- Interstitial Lung Disease (ILD): ILD is a rare condition that can present with cough, shortness of breath, and chest pain. Although unlikely, it could be considered in the differential diagnosis, especially if the patient has a history of exposure to potential triggers or other systemic symptoms.