It's upper respiratory infection (URI) season. The following is a clinical scenario drawn from my own practice. I'll tell you what I plan to do, but I'm most interested in crowdsourcing a response from all of you to collectively determine best practice. So please answer the polling questions and contribute your thoughts in the comments, whether you agree or disagree with me.
The Patient
The patient is a 69-year-old woman with a 3-day history of cough, nasal congestion, malaise, tactile fever, and poor appetite. She has no sick contacts. She denies dyspnea, presyncope, and chest pain. She has tried guaifenesin and ibuprofen for her symptoms, which helped a little.
She is up to date on immunizations, including four doses of COVID-19 vaccine and the influenza vaccine, which she received 2 months ago.
The patient has a history of heart failure with reduced ejection fraction, coronary artery disease, hypertension, chronic kidney disease stage 3aA2, obesity, and osteoarthritis. Current medications include atorvastatin, losartan, metoprolol, and aspirin.
Her weight is stable at 212 lb, and her vital signs today are:
Temperature: 37.5°C
Pulse: 60 beats/min
Blood pressure: 150/88 mm Hg,
Respiration rate: 14 breaths/min
SpO2: 93% on room air
Medscape Family Medicine © 2023
Cite this: Upper Respiratory Infections: Viral Testing in Primary Care - Medscape - Oct 23, 2023.
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