Differential Diagnosis for 59-year-old Male with Intermittent Fever, Chills, Night Sweats, Shortness of Breath, Cough, and Body Aches
- Single Most Likely Diagnosis
- Pneumonia: Given the symptoms of fever, chills, night sweats, cough, and shortness of breath, pneumonia is a highly likely diagnosis. The patient's age and history of CKD may also increase his susceptibility to respiratory infections.
- Other Likely Diagnoses
- Pulmonary embolism: Although the EKG is normal, pulmonary embolism can present with shortness of breath, cough, and fever, especially in a patient with a history of hypertension and CKD.
- Influenza or other viral respiratory infections: The patient's symptoms are consistent with a viral respiratory infection, and the fact that the EKG is normal and the presentation is viral in nature supports this diagnosis.
- Tuberculosis (TB): Given the patient's symptoms of fever, night sweats, and cough, TB should be considered, especially if the patient has been exposed to someone with TB or has a history of travel to an area with high TB prevalence.
- Do Not Miss Diagnoses
- Sepsis: Although the patient's symptoms may seem mild, sepsis can present with fever, chills, and shortness of breath, and it is crucial to consider this diagnosis to avoid missing a potentially life-threatening condition.
- Endocarditis: Despite the normal EKG, endocarditis can present with fever, chills, and shortness of breath, and it is essential to consider this diagnosis, especially in a patient with a history of hypertension and CKD.
- HIV-related opportunistic infections: Although the patient is on Descovy for PrEP, it is crucial to consider the possibility of HIV-related opportunistic infections, such as Pneumocystis jirovecii pneumonia (PCP), especially if the patient has not been adherent to his PrEP regimen.
- Rare Diagnoses
- Lymphoma: Although rare, lymphoma can present with fever, night sweats, and cough, and it is essential to consider this diagnosis, especially if the patient has a history of immunosuppression or other risk factors for lymphoma.
- Sarcoidosis: This rare condition can present with fever, cough, and shortness of breath, and it is essential to consider this diagnosis, especially if the patient has a history of autoimmune disorders or other risk factors for sarcoidosis.