A 22-year-old man with fevers, chills, and a non-productive cough

Abstract

A 22-year-old man with bipolar disorder and anxiety presented with fevers, chills, nausea, vomiting, and a non-productive cough for four days He reported a fever up to 40°C at home and an inability to tolerate oral intake for approximately two days His cough was dry and not associated with sputum production or hemoptysis He endorsed headaches and diarrhea as associated symptoms He reported a significant tetrahydrocannabinol (THC) and nicotine vaping history, which included the use of two nicotine cartridges and one THC cartridge daily His last use was approximately 1 week prior to presentation He denied neck pain and stiffness, leg swelling, dysuria, and abdominal pain There was no personal or family history of thromboembolism His home medications, taken daily, included lamotrigine and escitalopram He had no recent travel history or sick contacts The patient lived in a college dormitory in a major U S city He had no pets or recent contact with birds He denied any known exposure to heavy metals, agricultural chemicals, or any dyes, foams, and resins The patient had also never been exposed to toxic gases such as chlorine It should be noted that this patient presented to the hospital for care approximately four months before the first U S case of COVID-19, and as such, this is not investigated as part of the work-up