Differential Diagnosis for Ana's Persistent Cough
- Single Most Likely Diagnosis
- Pertussis (Whooping Cough): Given the persistent cough, on and off fevers, and vomiting triggered by coughing, pertussis is a strong consideration, especially since the patient has been treated for strep throat but symptoms persist. The recent move into a house with mice and rats could also suggest exposure to diseases carried by rodents, but the clinical presentation leans more towards a respiratory infection like pertussis.
- Other Likely Diagnoses
- Influenza: Although the patient denies runny nose and sore throat, influenza can present with cough and fever, and the fact that mom and grandpa are also sick suggests a possible infectious cause that could be influenza.
- Bronchitis: This could be a consideration given the cough and fever, especially if the patient has been exposed to respiratory pathogens.
- Asthma: If the cough is persistent and especially if it's worsened by the environment (e.g., exposure to allergens in the new home), asthma could be a differential diagnosis, though typically, asthma would also include wheezing and shortness of breath.
- Do Not Miss Diagnoses
- Tuberculosis (TB): Although less likely, TB is a critical diagnosis not to miss due to its severity and the need for prompt treatment. The recent move into a house with potential environmental exposures and the persistent nature of the cough could raise concerns, though classic symptoms of TB include weight loss, night sweats, and a more chronic cough.
- Pneumonia: Bacterial pneumonia could present with cough, fever, and vomiting, especially if the patient has been vomiting due to coughing. It's crucial to consider pneumonia due to its potential severity, especially in a pediatric patient.
- Rare Diagnoses
- Hantavirus: Given the recent move into a house with mice and rats, hantavirus could be a rare but potential diagnosis. Hantavirus pulmonary syndrome (HPS) is characterized by a severe respiratory illness, but it typically follows a more severe clinical course than what's described.
- Leptospirosis: Another disease carried by rodents, leptospirosis can cause a wide range of symptoms including fever, headache, and cough, but it's less common and would typically be associated with more systemic symptoms or exposure to contaminated water.