[24F] Pregnant with worsening dry cough and chest pain

Patient Description

A 24-year-old female, currently 23 weeks and 3 days pregnant, is experiencing a moderate to severe dry, barky cough that has been worsening over the past 48 hours. The cough began as a mild, wet cough but has progressed to become more painful, causing chest and ear pain, and is accompanied by extreme fatigue and chills. The patient has not been vaccinated against whooping cough or influenza but is up to date with COVID-19 vaccinations. She has been in close contact with sick individuals recently. She has no known allergies, no pre-existing conditions, and is currently taking Tylenol (1,000 mg every 8 hours) for the pain associated with the cough, as well as prenatal vitamins. She has not yet sought medical attention for this cough.

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Arora's Assessment

What might be happening

Based on the information you have provided, possible diagnoses include:

  • Influenza (Flu): The flu is a common viral infection that can be deadly, especially in high-risk groups. The flu attacks the lungs, nose, and throat. Symptoms include a cough, fever, chills, and fatigue.

    • Treatment typically includes rest, fluids, and over-the-counter medication to manage symptoms. Antiviral medication may be prescribed by a doctor.
  • Pertussis (Whooping Cough): Pertussis is a highly contagious respiratory tract infection. Although it initially resembles an ordinary cold, it eventually turns into severe coughing that sounds like "whooping".

    • Treatment usually involves antibiotics to kill the bacteria causing the infection.
  • COVID-19: A disease caused by a coronavirus, which can lead to severe respiratory problems. Symptoms can range from mild to severe and may appear 2-14 days after exposure.

    • Treatment involves supportive care to relieve symptoms and, in severe cases, hospital care.
  • Pneumonia: An infection that inflames the air sacs in one or both lungs, which may fill with fluid. With pneumonia, you might have a fever, cough with phlegm, and trouble breathing.

    • Treatment depends on the type and severity of your pneumonia, your age and overall health.

What you can do

It would be best to consult a doctor about your symptoms as soon as possible. They can provide a formal assessment and order relevant tests if necessary. In the meantime, you can try the following to relieve your symptoms:

  1. Continue to take Tylenol as directed to manage your pain.
  2. Drink plenty of fluids to stay hydrated and soothe your throat.
  3. Rest as much as possible to help your body fight the infection.
  4. Avoid contact with others to prevent spreading any potential infection.

What you should look out for

Reasons to seek immediate medical attention:

  • If you have difficulty breathing or experience shortness of breath
  • If your symptoms worsen or do not improve after a few days
  • If you develop a high fever (temperature over 100.4°F)
  • If you start coughing up blood

Remember, this advice is intended to be general in nature, and specific causes may not apply to your situation. Always consult with a healthcare provider for appropriate examination, testing, and care.

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1 yr ago

People Also Ask


What are the risks of having influenza during pregnancy?

Influenza during pregnancy can lead to more severe illness compared to non-pregnant individuals. It increases the risk of complications such as pneumonia, preterm labor, and low birth weight. Pregnant women are advised to get the flu vaccine to reduce these risks.


How can I differentiate between a common cold and whooping cough?

Whooping cough often starts with cold-like symptoms but progresses to severe coughing fits that can end with a 'whooping' sound. A common cold usually has milder symptoms and does not include the characteristic whooping cough sound.


What precautions should I take if I suspect I have COVID-19 while pregnant?

If you suspect you have COVID-19 while pregnant, it's important to isolate yourself to prevent spreading the virus, monitor your symptoms closely, and contact your healthcare provider for guidance. They may recommend testing and specific care based on your symptoms.


What are the signs that a cough might be due to pneumonia?

Signs that a cough might be due to pneumonia include a persistent cough with phlegm, high fever, difficulty breathing, chest pain, and fatigue. If you experience these symptoms, especially if they worsen, seek medical attention promptly.


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