Differential Diagnosis for Acute Cough
Given the symptoms of night sweats, productive cough, and weight loss for the past 3 weeks, the following differential diagnoses are considered:
- Single Most Likely Diagnosis
- Tuberculosis: The combination of night sweats, productive cough, and weight loss are classic symptoms of tuberculosis, especially in the context of a prolonged duration of symptoms.
- Other Likely Diagnoses
- Pneumonia: Although pneumonia typically presents with a more acute onset, some cases can have a subacute presentation, and the productive cough could be consistent with this diagnosis.
- Bronchitis: Chronic bronchitis could explain the productive cough, and while it doesn't typically cause night sweats or significant weight loss, it's a possibility, especially if the patient has a history of smoking or chronic lung disease.
- Asthma Exacerbation: If the patient has a history of asthma, an exacerbation could present with a cough, although night sweats and weight loss would be unusual symptoms.
- Do Not Miss Diagnoses
- Pulmonary Embolism: Although less likely given the chronic nature of the symptoms, pulmonary embolism can present with a variety of symptoms, including cough, and is a potentially life-threatening condition that must be considered.
- Rare Diagnoses
- Lung Cancer: While less likely in the absence of other symptoms like hemoptysis or a significant smoking history, lung cancer can present with cough, night sweats, and weight loss, and should be considered, especially if the chest x-ray shows a mass.
- Fungal Infections: Certain fungal infections, such as histoplasmosis or coccidioidomycosis, can present with similar symptoms, although they are less common and typically require specific exposures or risk factors.