Differential Diagnosis for a 15-year-old Female with Respiratory Symptoms
Single Most Likely Diagnosis
- Acute Bronchitis: This is the most likely diagnosis given the symptoms of cough, productive cough, chills, fever, and hoarseness. Acute bronchitis is a common condition in adolescents, often caused by a viral infection, and its symptoms align closely with those presented.
Other Likely Diagnoses
- Influenza: The combination of cough, fever, chills, and hoarseness could also suggest influenza, especially during flu season. The presence of nausea and vomiting further supports this possibility, as gastrointestinal symptoms can occur with the flu.
- Pneumonia: Although less likely than acute bronchitis without additional symptoms like shortness of breath or chest pain, pneumonia is a consideration, especially if the fever is high and the cough is productive with colored sputum.
- Acute Laryngitis: Hoarseness is a key symptom that points towards acute laryngitis, which could be caused by a viral infection. This condition often presents with a hoarse voice, cough, and sometimes fever.
Do Not Miss Diagnoses
- Pertussis (Whooping Cough): Although vaccination is common, pertussis can still occur, especially in adolescents whose immunity may be waning. The cough and hoarseness could be indicative of pertussis, which is a critical diagnosis not to miss due to its contagiousness and potential for severe complications.
- Tuberculosis (TB): While less common, TB is a critical diagnosis not to miss, especially if the patient has been exposed to someone with TB or has risk factors such as immunocompromised status. Chronic cough, fever, and hoarseness could be symptoms of TB.
- Epiglottitis: This is a medical emergency characterized by severe sore throat, difficulty swallowing, high fever, and drooling. Although the symptoms presented do not fully align, any sign of respiratory distress or severe throat pain warrants consideration of epiglottitis.
Rare Diagnoses
- Cystic Fibrosis: If the patient has a history of recurrent respiratory infections or other suggestive symptoms like failure to thrive, cystic fibrosis could be considered, though it would be rare for it to first present at this age without prior symptoms.
- Foreign Body Aspiration: This is more common in younger children but could occur in adolescents, especially if they have a history of putting objects in their mouths. Symptoms can include sudden onset of cough, choking, or difficulty breathing.
- Lung Abscess: A rare condition that could present with fever, cough, and sometimes nausea and vomiting. It would typically follow a pneumonia or be associated with specific risk factors like immunocompromised status or right-sided endocarditis.