Differential Diagnosis for 18 F with Cough, Fever, Congestion
Single Most Likely Diagnosis
- Viral Upper Respiratory Tract Infection (URTI): This is the most common cause of cough, fever, and congestion in an otherwise healthy young adult, especially given the acute onset since Friday. The symptoms are typical for a common cold or flu.
Other Likely Diagnoses
- Influenza: Given the symptoms of cough, fever, and congestion, influenza is a strong consideration, especially during flu season. The acute onset and combination of symptoms are consistent with the flu.
- Acute Bronchitis: This could be a consideration if the cough is prominent and the patient has a history of smoking or exposure to irritants. However, in a young adult without such risk factors, it's less likely.
- Pneumonia: Although less likely without additional symptoms like shortness of breath, chest pain, or high fever, community-acquired pneumonia is a possibility, especially if the symptoms worsen or do not improve with time.
Do Not Miss Diagnoses
- Pertussis (Whooping Cough): Although vaccination is common, waning immunity can lead to outbreaks. A persistent cough, especially with a whooping sound, would be indicative, but even without, it's crucial to consider due to its contagious nature and potential severity in infants and those with compromised immune systems.
- Tuberculosis (TB): While less common, TB can present with chronic cough, fever, and other systemic symptoms. It's essential to consider, especially if the patient has been exposed to someone with TB, has a weakened immune system, or has recently traveled to or immigrated from an area with high TB prevalence.
- COVID-19: Given the ongoing pandemic, COVID-19 must be considered, especially if the patient has been exposed to someone with COVID-19, has recently traveled, or is in an area with high transmission rates. Symptoms can range from mild to severe and include cough, fever, and congestion.
Rare Diagnoses
- Sarcoidosis: A systemic disease that can affect the lungs, causing cough and respiratory symptoms. It's less common and usually presents with additional symptoms like skin lesions, eye symptoms, or lymphadenopathy.
- Lymphoma: Although extremely rare as a cause of acute respiratory symptoms, lymphoma can cause cough, fever, and congestion, especially if there is mediastinal involvement. It would typically be associated with other systemic symptoms like weight loss or night sweats.
- Cystic Fibrosis: If the patient has a history of recurrent respiratory infections or other suggestive symptoms like malabsorption, cystic fibrosis could be considered, though it's rare and typically diagnosed in childhood.