Reference no: EM133296487

Case: A 60-year-old man with a past medical history of gastroesophageal reflux disease (GERD) and dyslipidemia presented to his family physician for evaluation of chronic cough. Five years prior, the patient had developed a high fever and respiratory symptoms, including a cough, and was believed to have had severe otitis media. He was treated with multiple courses of antibiotics and corticosteroids for persistent otitis media. Although the condition eventually resolved, his cough continued.

The persistent cough prompted the patient to consult a succession of specialists. First, he saw a gastroenterologist; following an esophagogastroduodenoscopy, he was prescribed pantoprazole. Despite the proton-pump inhibitor (PPI) therapy, the cough remained. Next, he had multiple visits with an otolaryngologist but that yielded no specific diagnosis for the cough. He also saw an allergist-immunologist, who identified a ragweed allergy, gave him a diagnosis of cough-variant asthma, and prescribed antihistamines and mometasone furoate and formoterol fumarate dihydrate. Neither was helpful.

After 5 years of frustration, the patient complained to his family physician that he still had a cough and "a tickle" in his throat that was worsened by speaking and drinking cold beverages. He denied fever, shortness of breath, nausea, vomiting, or any other associated symptoms.

Question: About this case say presumptive diagnosis. differential diagnoses and a brief explanation of each, minimum 3 differential diagnoses. What would be the treatment and health plan for this patient.