A 16-year-old boy with no significant medical history presented to the emergency department with a 1-week history of dry, non-productive cough associated with shortness of breath and headaches. No history of fevers, vomiting, diarrhea, throat or ear pain, or recent travel was noted. Emergency room observations In the ED, tachycardia (heart rate of 125 beats per minute) and hypoxia (oxyhemoglobin saturation of 86% on room air) were noted. The patient’s saturations improved to 99% after starting supplemental oxygen.
Physical exam was notable for the presence of bibasilar bronchial breath sounds with fine crackles over the upper lobes and decreased air entry in the lower lobes. There was no lymphadenopathy and no digital clubbing. A chest X-ray was ordered (Image attached). Laboratory reports C-reactive protein and erythrocyte sedimentation rate were both mildly elevated (4.6 mg/L and 16…
