An 18-year-old febrile patient with malaise and rhonchi is taking antibiotics for an upper respiratory infection. What is the likely diagnosis?

The presence of fever, malaise, and rhonchi in an 18-year-old patient taking antibiotics for an upper respiratory infection strongly suggests bronchitis as the likely diagnosis. Bronchitis is characterized by inflammation of the bronchi and commonly occurs in association with viral infections, which can lead to symptoms resembling those seen in upper respiratory infections.

In this case, the patient is febrile, indicating an infection. The malaise points to a systemic response from the inflammation, while rhonchi—abnormal lung sounds often described as low-pitched wheezing or snoring—suggest obstruction or secretions within the airways, which align with bronchitis.

While pneumonia also presents with fever and could cause similar respiratory symptoms, it typically involves more severe clinical signs such as productive cough with purulent sputum, localized lung findings, or diminished breath sounds, which are not specified here. Chronic obstructive pulmonary disease (COPD) is unlikely in an 18-year-old without a significant smoking history. Acute respiratory distress syndrome (ARDS) is characterized by severe respiratory distress and would likely show more extreme symptoms not indicated by the current presentation.

Therefore, given these symptoms and the context of an upper respiratory infection, bronchitis is the most fitting diagnosis