Differential Diagnosis for a 16-year-old Male with Respiratory Symptoms
Single Most Likely Diagnosis
- Acute Bronchitis: This is the most likely diagnosis given the symptoms of cough, congestion, chest pain, and production of phlegm, especially with clear lung sounds. Acute bronchitis is a common condition characterized by inflammation of the bronchial tubes, often caused by a viral infection.
Other Likely Diagnoses
- Viral Upper Respiratory Tract Infection (URTI): Symptoms such as runny nose, cough, and congestion are typical of a viral URTI. The presence of phlegm and chest pain could indicate the infection has affected the lower respiratory tract to some extent.
- Influenza: Although the lung sounds are clear, influenza can present with similar symptoms, including cough, chest pain, and production of phlegm, especially if the infection is not severe enough to cause significant lung consolidation.
- Allergic Rhinitis: If the symptoms are exacerbated by allergens, allergic rhinitis could be a contributing factor, especially with symptoms like runny nose and congestion.
Do Not Miss Diagnoses
- Pneumonia: Although lung sounds are clear, pneumonia should always be considered, especially if the patient's condition worsens or if there are signs of severe infection. It's crucial to monitor for any changes in symptoms or physical examination findings.
- Pulmonary Embolism: Though less common in a 16-year-old, pulmonary embolism can present with chest pain and cough. It's a critical diagnosis to consider due to its high mortality rate if untreated.
- Tuberculosis (TB): TB can present with chronic cough, chest pain, and production of phlegm. Although less likely, it's a diagnosis that should not be missed due to its public health implications and the need for specific treatment.
Rare Diagnoses
- Bronchiectasis: A condition characterized by permanent enlargement of parts of the airways, which can cause chronic cough and production of phlegm. It's less likely given the acute presentation but could be considered if symptoms persist.
- Cystic Fibrosis: An inherited disorder that causes severe damage to the lungs, digestive system, and other organs in the body. It's rare and typically presents in childhood, but could be considered if there's a family history or if symptoms persist and worsen over time.
- Sarcoidosis: A disease characterized by abnormal collections of inflammatory cells that can form in any part of the body, including the lungs. It's rare in adolescents and would be an unusual cause of these symptoms, but could be considered if other diagnoses are ruled out and symptoms persist.