a. History: Acute (< 3 weeks)

Differential Diagnosis

ACE inhibitor therapy, Acute Bronchitis, , Asthma, Allergic rhinitis,Common Cold, COVID-19, Influenza, Heart Failure, Pneumonia, Whooping cough (pertussis), Mycoplasma pneumoniae, Chlamydophila pneumoniae, Exposure to smoke, dust, chemicals, Seasonal allergies or hay fever, Pulmonary embolism, Congestive heart failure, Pneumothorax (collapsed lung), Foreign body aspiration,

 

[ACE inhibitor therapy, (a dry cough develops in up to 20% of patients taking an ACE inhibitor, usually within 1–2 weeks of therapy initiation) as well as less common causes.

When community influenza-like illness activity levels are high, clinical diagnosis of influenza (cough, fever, chills with or without sweats, myalgias, and acute onset) has a positive predictive value of approximately 70%; this usually obviates the need for rapid diagnostic tests to guide isolation and empiric treatment decisions. The CDC’s FluView displays weekly updates of influenza surveillance data (https://www.cdc.gov/flu/weekly/index.htm).]

 

Pivotal Assessment Finding

Further History

 Ace Inhibitor, Takes Chills Congestion, Chest Congestion, Nasal Cough greater than 2 weeks Fever
Paroxysms of coughing, inspiratory whoop, or post-tussive emesis Pertusssis outbreak or known close contact with a confirmed case, the presence of a cough lasting ≥2 weeks is sufficient Runny Nose Sore Throat    
Physical Exam Heart rate greater than 100 beat per minute Sputum, Present