Differential Diagnosis for a 16-year-old Male with Respiratory Symptoms
Single Most Likely Diagnosis
- Viral Upper Respiratory Tract Infection (URTI): This is the most likely diagnosis given the symptoms of cough, congestion, runny nose with phlegm, and chest pain, which are typical of a common cold or viral upper respiratory infection. The presence of clear lung sounds also supports this diagnosis, as it suggests that the lower respiratory tract is not significantly involved.
Other Likely Diagnoses
- Acute Bronchitis: This condition could explain the cough and chest pain, especially if the patient has been producing phlegm. However, the clear lung sounds make this less likely than a pure upper respiratory infection.
- Allergic Rhinitis: If the patient has allergies, this could be a contributing factor to the runny nose, congestion, and cough, especially if the symptoms are seasonal or triggered by specific allergens.
- Sinusitis: Given the symptoms of congestion, runny nose, and facial pain (which could be inferred from the ear popping), sinusitis is a possible diagnosis, especially if the symptoms have persisted for more than a week.
Do Not Miss Diagnoses
- Pneumonia: Although the lung sounds are clear, pneumonia can sometimes present with minimal findings on physical examination, especially in the early stages. It's crucial to consider this diagnosis, especially if the patient has a high fever, significant chest pain, or shortness of breath.
- Pulmonary Embolism: This is less likely in a healthy 16-year-old but should be considered if there's a history of recent travel, immobilization, or family history of clotting disorders, along with symptoms like sudden onset of chest pain or shortness of breath.
- Tuberculosis (TB): Although less common, TB can present with chronic cough, chest pain, and systemic symptoms. A history of exposure or travel to endemic areas would increase the suspicion.
Rare Diagnoses
- Sarcoidosis: A systemic disease that can affect the lungs, presenting with cough, chest pain, and shortness of breath, but it's rare in adolescents and usually has other systemic symptoms.
- Interstitial Lung Disease: A broad category of diseases affecting the lung interstitium, which could present with cough and chest pain, but these are rare in adolescents and often have a more chronic course.
- Lymphoma: Although extremely rare, lymphoma can present with respiratory symptoms due to mediastinal involvement. This would be considered with systemic symptoms like weight loss, night sweats, or significant lymphadenopathy.