Cough with fever
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Understanding Cough with Fever: Causes and Case Studies
Common Causes of Cough with Fever
Infectious Diseases: Tuberculosis and COVID-19
Cough accompanied by fever is often indicative of infectious diseases. In regions with a high prevalence of tuberculosis, such as India, pulmonary tuberculosis is a primary consideration when patients present with chronic cough, fever, and weight loss. Similarly, COVID-19 has been identified as a significant cause of cough and fever, with studies showing that 78.2% of COVID-19 patients experience fever and 54.9% experience cough upon hospital admission.
Respiratory Infections and Tracheitis
Respiratory infections are a common cause of cough and fever. For instance, a 37-year-old male with a history of dry cough, fever, and dyspnea was initially diagnosed with tracheitis and treated with antibiotics and cough syrup, which provided only temporary relief. Another case involved a 19-year-old woman with recurrent episodes of fever and productive cough over two years, requiring multiple courses of antibiotics.
Non-Infectious Causes: Non-Hodgkin Lymphoma
Non-infectious conditions can also present with similar symptoms. A rare case involved a patient with bilateral suprarenal mass diagnosed as Non-Hodgkin lymphoma, presenting with chronic cough, fever, and weight loss, highlighting the need to consider extra-thoracic causes.
Case Studies Highlighting Diagnostic Challenges
Pediatric Cases
In pediatric patients, cough and fever can be particularly challenging to diagnose. A 2-year-old boy with a five-day history of cough and fever was initially treated with amoxicillin without improvement. Examination revealed respiratory distress and reduced air entry on the right side, leading to further investigation. Similarly, a 7-year-old girl with a seven-week history of daily fevers and worsening cough had persistently elevated inflammatory markers and required extensive diagnostic workup, including imaging and specialist consultations, before a diagnosis of severe purulent tracheitis was made.
Adult Cases
Adults can also present with complex cases. A 49-year-old man experienced three months of persistent fever, cough, and chest tightness, with no response to antibiotics or steroids, necessitating further investigation. Another case involved a 52-year-old man with an 11-month history of fever, cough, chest pain, and pleural effusion, initially suspected to have lung cancer but later found to have chronic inflammatory changes in the bronchi.
Conclusion
Cough with fever is a common clinical presentation that can be caused by a variety of infectious and non-infectious conditions. Accurate diagnosis requires careful consideration of patient history, clinical examination, and appropriate diagnostic tests. Understanding the potential causes and complexities of such cases can aid in timely and effective management.
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