IM- URTI
HIV - 01-02-08 16:35

A 30-year-old woman comes to the clinic complaining
of an annoying cough that she believes she caught from
her daughter.Apparently, her 3-year-old daughter started
attending a new day-care center earlier in the week
and quickly developed a productive cough. The patient
reports suffering 2 days of cough productive of thick
yellow sputum, low-grade fever, sore throat, and
malaise. Before this episode, she has been healthy. She
does not smoke, and, aside from the birth of her daughter,
she has not spent a day in the hospital. Vital signs
are unremarkable; the patient is afebrile and denies any
fevers or chills at home. Cardiac examination reveals a
regular rate and rhythm. Chest auscultation is remarkable
for coarse upper-respiratory breath sounds, but no
crackles, egophony, or dullness to percussion. She is
breathing comfortably, without use of accessory muscles
of respiration, at a rate of 14/min. There is no lymphadenopathy,
pharyngeal exudate, sinus pain, bronchospasm,
or dyspnea. Given this patient’s likely condition,
which of the following is the most appropriate
next step in her management?

(A) Chest radiograph
(B) Empiric macrolide antibiotics
(C) No treatment; follow clinically
(D) Sputum culture and Gram stain
(E) Viral serologies and culture