[68F] Persistent cough and fever with history of asthma and lymphoma

Patient Description

A 68-year-old female has been experiencing a persistent cough for over three weeks, accompanied by a sore throat, fluctuating fever, and laryngitis. The cough, which is worse at night, started as a deeper chest cough and has since moved to the throat. The patient describes the cough as constant and painful, leading to chest tightness and occasional shortness of breath. Greenish-gray phlegm is sometimes produced, but the cough is mostly dry. The patient has been taking benzonatate with only a couple of days left on the prescription. She has a history of non-Hodgkin's lymphoma, asthma, IBS, urinary incontinence, migraines, and a past TIA. Current medications include Lexapro, Topiramate, Albuterol, Prednisone, Benzonatate, Albuterol nebulizer, Oxybutynin, Levothyroxine, and various vitamins and supplements. The patient is allergic to latex and codeine. She reports no recent weight loss, night sweats, or cyanosis, but has noted a decrease in appetite and increased fatigue.

Arora's Assessment

What might be happening

Based on the information you've provided, possible diagnoses include:

Bronchitis: This is an inflammation of the lining of your bronchial tubes, which carry air to and from your lungs. Symptoms of bronchitis include coughing up thickened mucus which can be discolored. Bronchitis can be acute or chronic. Chronic bronchitis, a type of chronic obstructive pulmonary disease (COPD), is a serious condition that makes it hard to breathe and worsens over time. People with chronic bronchitis tend to get lung infections more easily.
- Treatment typically involves rest, staying well hydrated, and avoiding smoke and fumes. Over-the-counter cough remedies can help with symptom management. In some cases, your doctor may prescribe medications to reduce inflammation, open up your airways, or treat an underlying infection.
Pneumonia: This is an infection that inflames the air sacs in one or both lungs. The air sacs may fill with fluid or pus, causing cough with phlegm or pus, fever, chills, and difficulty breathing. Given your age and medical history, you are at a higher risk for developing pneumonia.
- Treatment typically involves antibiotics, fever reducers, and cough medicine. It's important to get plenty of rest and stay hydrated.
Asthma exacerbation: Your asthma may be poorly controlled, leading to an increase in the frequency and severity of symptoms.
- Treatment involves the use of long-term control medications to prevent symptoms and quick-relief (rescue) medications to control symptoms once they start.

Please note that these are potential explanations for your symptoms based on the information you've provided, and not a definitive diagnosis.

What you can do

Given the duration and severity of your symptoms, it's important to seek medical attention. Here are some steps you can take:

Contact your healthcare provider: They can evaluate your symptoms, perform necessary tests, and provide appropriate treatment.
Rest and hydrate: Make sure to get plenty of rest and stay well hydrated. This can help your body fight off an infection if that's what's causing your symptoms.
Monitor your symptoms: Keep track of any changes in your symptoms. If they worsen or you develop new symptoms, seek medical attention immediately.