[27F] With persistent cough, night sweats, and muscle pain

Patient Description

A 27-year-old female presents with a persistent cough lasting over three months, characterized by both dry and productive episodes with green, foul-tasting mucus. She reports significant muscle pain, particularly in the right armpit, exacerbated by movement and breathing. The patient also experiences night sweats, fatigue, nausea, and has noted an unintentional weight loss of approximately 5 pounds within a week. She describes sharp, stabbing chest pain, which is somewhat alleviated by hot showers or baths. The patient has no history of smoking or exposure to secondhand smoke but was exposed to black mold during a recent incarceration, which may contribute to her symptoms. She is currently being treated for pneumonia with Prednisone and Cefdinir, and takes Excedrin extra strength for pain relief every 12 hours. The patient has allergies to Z-pack and Bactrim, which cause hives and throat closure, respectively. No swelling in the legs or ankles has been observed, and there is no family history of respiratory or autoimmune diseases.

Arora's Assessment

What might be happening

Based on your symptoms and history, there are a few potential explanations for what you are experiencing:

Chronic Respiratory Infection or Complication: Given your history of upper respiratory infections, COVID-19, and current pneumonia treatment, it's possible that your symptoms are related to a persistent or complicated respiratory infection. The green, foul-tasting mucus and wheezing suggest ongoing infection or inflammation in your lungs. The exposure to black mold could also contribute to respiratory issues, as mold can exacerbate or cause respiratory symptoms.
Pleurisy or Costochondritis: The sharp, stabbing chest pain that worsens with breathing and movement might be due to pleurisy (inflammation of the tissues lining the lungs and chest cavity) or costochondritis (inflammation of the cartilage connecting the ribs to the breastbone). These conditions can cause significant pain and discomfort.
Side Effects of Medication: Some of your symptoms, such as nausea and fatigue, could be side effects of the medications you're taking, particularly if you're starting Prednisone, which can have various side effects.
Systemic Inflammatory Response: The combination of night sweats, weight loss, and fatigue could indicate a systemic inflammatory response, possibly related to an ongoing infection or another underlying condition.

What you can do

Respiratory Symptoms:

Continue taking your prescribed medications as directed by your healthcare provider. It's important to complete the full course of antibiotics.
Use a humidifier in your room to help ease breathing and reduce coughing.
Stay hydrated by drinking plenty of fluids, which can help thin mucus and make it easier to expel.
Avoid exposure to irritants like smoke, strong odors, and dust.

Chest Pain:

Apply a warm compress or heating pad to the affected area to help alleviate pain.
Practice deep breathing exercises to help expand your lungs and reduce pain.
Avoid activities that exacerbate the pain, and rest as needed.

General Well-being:

Ensure you get adequate rest to help your body recover.
Eat small, frequent meals to help manage nausea and maintain energy levels.
Consider using MDandMe to journal your symptoms, track progress, and share insights with your healthcare provider.

What you should look out for

Given the severity and persistence of your symptoms, it's important to seek medical attention if you experience any of the following:

Increased difficulty breathing or shortness of breath
High fever or chills
Persistent or worsening chest pain
Significant changes in mucus color or amount
New or worsening symptoms

Please remember that while I can provide information and suggestions, it's crucial to consult with a healthcare professional for a formal diagnosis and appropriate treatment.

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2 mo ago

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