Cough in a 54-yr-old Man

• General appearance: Tired-appearing, middle-aged male in no apparent respiratory distress.


• Vital signs
• Temperature: 38.5° C (101.3° F)
• Pulse: 98 beats/min
• BP: 128/74 mm Hg
• Respirations: 20/min


• Skin: Pink, warm, and slightly diaphoretic. No rash or cyanosis.


• HEENT: Clear rhinorrhea visible from nares and in posterior pharynx; pharynx slightly injected. No cervical adenopathy.


• Pulmonary: Breath sounds are equal bilaterally with good air entry and exit. Faint inspiratory crackles are present on the left side, heard more at the base. No wheezing is noted.


• Cardiovascular: No jugular venous distention visible at 45°. Heart regular; no murmurs, rubs or gallop. No peripheral edema.


• Gastrointestinal: Unremarkable


• Genitourinary: Unremarkable


• Musculoskeletal: No leg swelling, redness, or tenderness. No finger clubbing. There is a healed surgical scar on the right knee.


• Neurologic: Unremarkable


• Psychiatric: Alert; oriented to person, place, and time. Responds clearly and coherently to questions and commands.