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 patient's symptoms of cough, nausea, vomiting, productive cough, chills, fever, and hoarseness. The presence of clear lung sounds and tachycardia also supports this diagnosis, as acute bronchitis often presents with these symptoms and can be associated with asthma.
Other Likely Diagnoses
- Pneumonia: Although the patient has clear lung sounds, pneumonia should be considered, especially given the symptoms of fever, chills, and productive cough. It's possible that the pneumonia is in its early stages or is not yet severe enough to cause significant lung consolidation.
- Influenza: The symptoms of cough, fever, chills, and hoarseness are consistent with influenza, especially during flu season. The presence of nausea and vomiting also supports this diagnosis.
- Asthma Exacerbation: Given the patient's history of asthma, an exacerbation should be considered, especially if the symptoms are worsening or not responding to usual asthma treatments.
Do Not Miss Diagnoses
- Pertussis (Whooping Cough): This diagnosis is crucial to consider, especially if the patient is not up-to-date on vaccinations. Pertussis can present with a persistent cough, vomiting, and hoarseness, and can be severe if not treated promptly.
- Pulmonary Embolism: Although less likely in a 15-year-old, pulmonary embolism should be considered, especially if the patient has a history of clotting disorders or is taking estrogen-containing medications. The symptoms of tachycardia and cough could be indicative of a pulmonary embolism.
- Epiglottitis: This is a life-threatening condition that requires prompt diagnosis and treatment. Although the patient does not have the classic symptom of dysphagia, epiglottitis should be considered if the patient's condition worsens or if there are signs of respiratory distress.
Rare Diagnoses
- Tuberculosis (TB): Although rare in a 15-year-old, TB should be considered if the patient has been exposed to someone with TB or has recently traveled to an area with high TB prevalence. The symptoms of cough, fever, and hoarseness could be consistent with TB.
- Cystic Fibrosis: If the patient has a history of recurrent respiratory infections or has not been previously diagnosed with asthma, cystic fibrosis should be considered. The symptoms of productive cough and hoarseness could be consistent with cystic fibrosis.