STUDY – 28-YEAR- 1 1
OLD MALE WITH COUGH AND FATIGUE
1 1 1 1 1 1
Case Overview
1 1
Patient1Name:1Mr.1Brian1Collins1
Age:1281years1
Sex:1Male1
Date1of1Encounter:1April115,120251
Setting:1Primary1Care1Clinic1
Chief Complaint
1 1
"I’ve1had1this1cough1and1I1just1can’t1shake1off1the1tiredness1for1the1past1two1weeks."1
History of Present Illness (HPI)
1 1 1 1 1
Brian1Collins1is1a128-year-
old1male1presenting1with1a1persistent1dry1cough1and1fatigue1lasting1for1two1weeks.11
The1cough1began1gradually,1is1worse1at1night,1and1occasionally1accompanied1by1mild1chest1ti
ghtness.1He1denies1hemoptysis1or1significant1shortness1of1breath.11
Fatigue1is1constant1and1impacts1daily1work1performance.1He1denies1fever,1chills,1night1sweat
s,1or1weight1loss.11
He1has1mild1nasal1congestion1but1no1sore1throat.1Denies1recent1travel1or1tuberculosis1expos
ure.1
Past Medical History
1 1 1
Mild1seasonal1allergies;1no1asthma,1diabetes,1hypertension,1or1cardiac1disease.1
Social History 1 1
Non-
smoker,1social1alcohol1use,1accountant,1sedentary1lifestyle,1irregular1exercise,1lives1with1wife
1and1daughter,1no1recent1travel.1