Exploring other possibilities – differential diagnosis

Not all front-line healthcare workers will have had medical or nursing training. Given the case description, you may have the diagnosis of asthma or COPD in mind, but don’t forget other diagnoses. They may be harder to detail, but listen for other symptoms. Other possibilities include:

• Active TB/Latent TB
• Bronchiectasis/Bronchiectasis is a condition of repeated infections which damages the lung structure making the ‘flabby’ and scarred. The most important symptom of bronchiectasis is a cough every day which produces a lot of mucous. Some people also become short of breath or have pains around the chest. Further information can be found on the National Heart, Lung, and Blood Institute website.
• Lung cancer often presents with a cough which gets worse over a few weeks or months. It may be associated with fatigue, or weight loss. Anyone who coughs up blood should have tests (such as a chest X-ray) to look for lung cancer.
• Occupational causes. Many dusty jobs can cause lung disease so if symptoms started after working in a dusty workplace, or they get better when away from work, it may need some tests (such as a chest X-ray or spirometry) to find out the cause.
• Pneumonia is an infection which usually comes on quickly with a fever and a cough. It can usually be treated so it important to see a doctor quickly
• Whooping cough is an infection with very sticky sputum that it can be difficult to cough up. This causes spasms of coughing that can go on for weeks.