A new 35 yo patient is referred to you for evaluation of cough. She has had 2 weeks of non-productive cough that has been worsening, to the point of her having fits of cough and post-tussive emesis. Her symptoms started she experienced generalized malaise, but no fever or chills. She denies post-nasal drip, and has no medical problems. When reconciling her medications, she is only taking motrin for intermittent pain, and has an allergy to macrolides. Family history reveals she has a 2 year old daughter that goes to daycare.
How should you proceed in evaluating her cough?
What infectious and noninfectious etiologies should be considered?
Based on your differential diagnoses, what treatment do you offer?
http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5414a1.htm
John Kioka and I are at CC and we think we would treat with Bactrim, given her macrolide allergy. Our suspicion is for pertussis.