68 years old female presents with an increase in airways' mucus production within last few days.

Patient has severe dyspnea at rest and exertion (can't speak almost at all), and has thick airways' mucus production.

Review of systems: She has severe cough, has history of fevers, and had no contact with others with signs or symptoms of infection.

Patient history revealed that patient has not been on dialysis, has not been living in a nursing home or other long-term care facility, and has not been hospitalized for more than 48 hours within the preceding 90 days. Additionally she has not been using any IV antibiotics within last 30 days.

Social history revealed that patient has 24 pack-years history of smoking, and has no risk for exposure to COVID-19 (SARS-CoV-2).

There is no relevant family history.

Physical examination: blood pressure 136/70 mmHg, heart rate of 70/min, temperature of 39.1 C (102.4 F), respiratory rate of 15/min, BMI of 19.44 kg/m2, and oxygen arterial saturation 98% on room air. Lungs' auscultation is positive for grossly asymmetric scattered inspiratory rales, mostly at the right base, is negative for decrease in breath sounds, is negative for wheezing, and is negative for rhonchi.

Serum procalcitonin (PCT) is 1.61 ng/ml (mcg/l). Blood white cells (WBC) is 19879 /ul. Chest x-ray shows no pleural effusion, and revealed no focal infiltrate.

What is the most probable diagnosis?

84 years old female presents with dyspnea, progressive over last few days. She has moderately severe cough, and has thick airways' mucus.

Review of systems: She has an increase in airways' mucus production within last few days, had contact with a friend who suffered from a runny nose, sore throat and mild fever, and has history of fevers.  Patient has moderate dyspnea at rest and can speak in short, couple words long sentences.

Social history revealed that patient has 12 pack-years history of smoking. There is no relevant family history.

Physical examination: blood pressure 133/40 mmHg, heart rate of 70/min, temperature of 37.8 C (100 F), respiratory rate of 15/min, BMI of 23 kg/m2, and oxygen arterial saturation 93% on room air.  Lungs' auscultation is positive for bilateral expiratory wheezing, is positive for bilateral rhonchi, is negative for decrease in breath sounds, and is negative for inspiratory rales.

Chest x-ray revealed no focal infiltrates, and shows no pleural effusion.
Blood white cells (WBC) is 2703/ul. Arterial blood gasses pCo2 is 104.4 mmHg.

What is the most probable diagnosis?

38 years old male presents with severe, copious, airways' mucus production, with each coughing spell. He has sore throat, and has a moderately severe cough.
Review of systems: The patient has no mucus production, and has no hemoptysis. He has fatigue.

Social history revealed that he has a patient's child, who lives with the patient, was recently tested positive for COVID-19 (SARS-CoV-2), and has no history of smoking.

There is no relevant family history.

Physical examination: blood pressure 106/48 mmHg, heart rate of 70/min, temperature of 38.7 C (101.6 F), respiratory rate of 17/min, BMI of 25.75 kg/m2, and oxygen arterial saturation 98% on room air. Lungs' auscultation is positive for bilateral inspiratory rales, and is negative for decrease in breath sounds. Neck and throat examination is essentially normal.

What is the most likely diagnosis?

42 years old male presents with a moderately severe cough. He has mild subjective dyspnea at rest, but is able to speak full sentences, and had contact with a friend who suffered from a runny nose, sore throat, and mild fever.

Review of systems: He has no airways' mucus production, and has no increase in airways' mucus production within the last days.  The patient has no history of fevers.

Review of past history revealed that the patient has a history of atopic dermatitis in early childhood, without recurrence of symptoms in adulthood.

Social history revealed that he has 6 pack-years history of smoking. There is no relevant family history.

Physical examination: blood pressure 109/47 mmHg, heart rate of 94/min, temperature of 36.4 C (97.5 F), respiratory rate of 26/min, BMI of 21 kg/m2, and oxygen arterial saturation 95% on room air. Lungs' auscultation is positive for bilateral expiratory wheezing, is negative for rhonchi, is negative for inspiratory rales, and is negative for decrease in breath sounds.

Serum procalcitonin (PCT) is 0.2 ng/ml (mcg/l). Arterial blood gasses pCo2 is 33.2 mmHg. Blood d-dimer (DD) is 0.44 mg/l (mcg/ml). Chest x-ray revealed no focal infiltrates, shows no pleural effusion, and has no features of pulmonary edema.

What is the most probable diagnosis?

96 years old female presents with thick airways' mucus production. She has an increase in airways' mucus production within last few days, and has mild subjective dyspnea at rest, but is able to speak full sentences.

Review of systems:  She has cough of mild severity and has history of fevers.

Patient history revealed that patient has had hemodialysis as inpatient last week, as the patient has end stage renal disease (ESRD), has been staying in a nursing home or other long-term care facility, and has been hospitalized for 4 days 3 weeks ago.

Social history revealed that she has 24 pack-years history of smoking, and has no risk for exposure to COVID-19 (SARS-CoV-2).

There is no relevant family history.

Physical examination: blood pressure 125/70 mmHg, heart rate of 70/min, temperature of 43.3 C (109.9 F), respiratory rate of 15/min, BMI of 21.13 kg/m2, and oxygen arterial saturation 98% on room air. Lungs' auscultation is positive for left sided decrease in breath sounds, is positive for right-sided expiratory wheezing, is positive for fine bibasilar inspiratory rales, and is positive for left-sided, rhonchi.

Serum procalcitonin (PCT) is 1.88 ng/ml (mcg/l). Blood lymphocyte level is 6103.7/ul. Chest x-ray has findings of bilateral focal infiltrates, and shows left sided pleural effusion.

What is the most likely diagnosis?