M.W. is a 28 y.o. F patient that presents with 3-4 days of dry, non-productive cough, febrile up to 100.8F, chills, and chest discomfort. Patient reports she generally runs 2 miles outside each morning prior to work. She has been too fatigued and overall “not well enough” to complete even 1 mile. Her cough is also exacerbated during and after the run. Patient reports nasal congestion began about 2 days prior to cough. Patient denies any history of smoking. Appetite somewhat decreased, but otherwise normal. She denies any recent known exposures. Patient works as a paralegal at a law firm.
On exam, the patient’s vital signs include: oral temp: 99.8F, radial pulse: 87, RR: 20, BP: 124/80, oxygen saturation: 98%. Mucous membranes, pink, moist, and intact. Breath sounds are clear and equal bilaterally upon auscultation to anterior and posterior chest. Throughout conversation, patient has a few episodes of dry, non-productive coughing spells. Bowel sounds audible and active in all 4 quadrants. Capillary refill < 2s.
Patient is sent for a chest x-ray, which is negative for infiltrates. Lungs appear clear according to the radiology read.