Cough in a 54-yr-old Man

Review of Systems

  • General: Patient felt fine until about 4 days ago. He thinks he has had a fever but did not take his temperature. He had a shaking chill last night that shook the bed and alarmed his wife. He feels quite “run down” and was too sick to go to work today so he came in. Before onset of this illness, he felt fine and was doing all his normal activities. He has been eating normally with no recent weight loss.

  • Skin: Has not noticed rash or skin lesions.

  • HEENT: Runny nose and mild sore throat began about 4 days ago. Rhinorrhea is clear. He is able to swallow with only mild discomfort. He has not noticed swollen nodes in his neck.

  • Pulmonary: He has had dyspnea when climbing stairs since illness began but no dyspnea at rest. He feels vague, continuous “discomfort” in the left side of his chest, and he has a sharp pain with inspiration. He denies wheezing.

  • Cardiovascular: There is no exertional chest pain, palpitations, orthopnea, or paroxysmal nocturnal dyspnea.

  • Gastrointestinal: He has had a poor appetite for several days but is able to eat and drink. He denies reflux symptoms.

  • Genitourinary: Noncontributory

  • Musculoskeletal: He has right knee pain with exertion. He has not noticed any pedal edema.

  • Neurologic: Noncontributory

  • Psychiatric: Noncontributory