Dyspnea in a 57-Year-Old Man With Recent Viral Illness

A 57-year-old man presented to the ED with a 1-month history of nonproductive cough and shortness of breath. The patient had been in his usual state of health until 2 months before presentation, when he experienced an episode of nonproductive cough and shortness of breath. He was diagnosed clinically with an upper respiratory tract infection; the symptoms resolved after 7 days with conservative therapy alone. One month later, the nonproductive cough and shortness of breath returned. He was treated with a 5-day course of oral azithromycin without any improvement in his symptoms. On presentation to the ED, he denied fever, chills, night sweats, chest pain, arthralgia, myalgia, or hemoptysis. His medical history was significant for hypertension, poorly controlled type 2 diabetes mellitus, and coronary artery bypass grafting. His medications included aspirin, metoprolol, metformin, and glipizide. He denied any history of tobacco, vaping, or recreational drug use. He worked as a cashier in a departmental store and has been doing so for most of his life.