A 34 year old Hispanic woman presents to the clinic with cough, head congestion, possible fevers and sneezing. This has been going on for 2-3 days. She also has had trouble breathing due to the coughing, and has a history of asthma. Nobody else in the home is sick. She has no other relevant past medical history. Her main concern is that she might get her infant child sick. However, she says both she and child are up to date on their vaccines. She says she got a Tdap shot at the hospital while pregnant.
The exam was repeatedly interrupted by the patient’s coughing fits. She often had to stand up from the exam table due to the intense coughing spasms that left her gasping for air. The gasps were loudly audible with a high-pitched, airy roar. The patient said she otherwise felt fine in between these coughing spasms; the head congestion was no big deal. The patient’s vital signs, including her oxygen saturation, were normal. The lungs sounded clear on exam. A chest X-ray was unremarkable.
AT THIS POINT, I WAS 99% SURE OF THE DIAGNOSIS. WHAT IS YOUR GUESS?