Table of Contents
Common Questions
Chat with CodyMD
Cody's Chat with Patient
Cody's AI Summary
Top 3 AI Diagnosis List
Review by Dr Albert DiPiero
Dr. DiPiero Video Guide to this Case Study
Resource Center
Testimonials
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Case Study
Meet your host
Albert DiPiero, MD MPH FACP
I am a co-founder and the Chief Medical Officer at CodyMD and your host for this edition of Cody Grand Rounds. I have been a practicing physician and faculty member at medical schools for over 26 years.
About The AI Doctor Case Study
CodyMD is a partnership between Human Doctors and AI Doctors. Cody is an AI Doctor who helps thousands of people every day. At each Cody Grand Rounds, I select a real case and review it with Cody, the AI Doctor.
Each case is based on a real patient but has been modified to maintain privacy and to emphasize certain teaching points.
Common Questions
What could be causing my severe cough?
Can AI diagnose a cough?
What are the symptoms of viral bronchitis?
How can I tell if my mucus is a sign of infection?
Is a low fever concerning with a cough?
What should I do if my COVID-19 home tests are negative but I still have symptoms?
How can AI help with diagnosing allergies and respiratory issues?
Chat with CodyMD
Click the button below to initiate a conversation with CodyMD, your AI Doctor.
Cody's Chat with Patient
Below is a conversation transcript between the patient and our AI Doctor CodyMd.
Cody, the AI Doctor
Good to meet you! I understand you want to focus on your cough today. Is that correct?
Patient
Yes, that's right.
Cody, the AI Doctor
My goal is to provide you with an accurate assessment and plan. Let's talk about your concerns regarding the cough. How did it start? Was it sudden or gradual?
Patient
It started suddenly, about five days ago.
Cody, the AI Doctor
How would you rate the severity of your cough on a scale from 1 to 10, with 10 being the most severe?
Patient
I would say it's about a 6 out of 10.
Cody, the AI Doctor
That sounds quite uncomfortable. Do you have any chronic illnesses that you are aware of, such as asthma or allergies?
Patient
I don't have any chronic illnesses or asthma, but I do have seasonal allergies.
Cody, the AI Doctor
Thank you for that information. Are you currently on any medications?
Patient
No, I'm not taking any medications.
Cody, the AI Doctor
Understood. Do you smoke?
Patient
No, I don't smoke.
Cody, the AI Doctor
Is your cough productive? Are you coughing up any mucus?
Patient
Yes, occasionally I'm coughing up some yellowish mucus.
Cody, the AI Doctor
Have you experienced any fever along with this cough?
Patient
I've had a low fever a couple of times, around 99.6 degrees.
Cody, the AI Doctor
Besides the cough and fever, are you experiencing any other symptoms, like nasal congestion or headaches?
Patient
Yes, my nose is quite congested and I have a mild frontal headache.
Cody, the AI Doctor
Are you experiencing any chest pain or shortness of breath?
Patient
No chest pain or shortness of breath.
Cody, the AI Doctor
Have you done any tests for COVID-19?
Patient
Yes, I did a home test twice and both were negative.
Cody, the AI Doctor
That's helpful to know. Now, let's summarize your symptoms.
Cody's AI Summary
- You are a 45-year-old woman with sudden onset of severe cough for the past five days, which you rate as 6 out of 10.
- You have no history of chronic illnesses, including asthma, but you do have seasonal allergies.
- You are not taking any medications and do not smoke. Your cough is occasionally productive of yellowish mucus and you have experienced a low fever around 99.6 degrees occasionally.
- Additionally, you have a congested nose and mild frontal headache. You have no chest pain or shortness of breath.
- You have done a home test for COVID-19 twice, and both were negative.
Top 3 AI Diagnosis List
Based on the information and conversations with Cody, we have prepared a top 3 AI Diagnosis List.
1. Viral Bronchitis( 60 % probability)
An inflammation of the bronchial tubes usually caused by a viral infection. It often presents with a severe cough, production of mucus, and sometimes a low-grade fever. Your symptoms align well with this condition.
2. Bacterial Sinusitis(25 % probability)
An infection of the sinuses that can lead to congestion, cough, and headaches among other symptoms. The yellowish mucus and frontal headache could suggest this condition.
3. Pneumonia(15 % probability)
A lung infection that can cause fever, cough, and mucus production. Although you don’t have chest pain or shortness of breath, it's worth considering given the severity of your symptoms.
Review by Dr Albert DiPiero
Dr. Albert DiPiero
This case presents a 45-year-old woman with a sudden onset severe cough, nasal congestion, mild frontal headache, and occasional low-grade fever. She has a history of seasonal allergies but no chronic illnesses, is not on any medication, and does not smoke. She has also tested negative for COVID-19.
1. Viral Bronchitis(80% probability)
This is the most likely diagnosis given the acute onset of symptoms, fever, productive cough with yellowish mucus, and nasal congestion. Viral bronchitis commonly follows a typical upper respiratory tract infection pattern, which matches the patient's history.
2. Bacterial Sinusitis(15% probability).
This condition is also plausible due to the presence of yellowish mucus, nasal congestion, and frontal headache. However, the absence of facial pain or significant purulent discharge lessens the probability slightly compared to viral bronchitis.
3. Pneumonia(5% probability)
Although pneumonia is less likely without chest pain or shortness of breath, the severity of the cough and fever warrants consideration. Imaging studies such as a chest X-ray could help in ruling this out.
Next Steps for Evaluation
Diagnostic Testing: I would first want to know her pulse rate and oxygen saturation, which could be obtained from a smart watch if she has one. Additional diagnostic tests like a chest X-ray could provide more clarity, particularly to rule out pneumonia. Given the current history I would not feel this is required at this point.
Potential Treatment Modalities
Symptomatic Treatment:
On assumption that viral bronchitis is the primary diagnosis, supportive care including increased fluid intake, humidified air, and rest would be recommended. If symptoms change such that she has an increased fever, worsening cough, or any shortness of breath, then she should be re-evaluated in person. If her current symptoms persisted over 10 days that could be an indication for reassessment antibiotic treatment.
Medical Treatment:
If bacterial sinusitis is confirmed, appropriate antibiotics could be initiated. Over-the-counter decongestants may also help relieve symptoms.
Conclusion:
Based on the symptoms and initial assessment, viral bronchitis is the most probable diagnosis. However, bacterial sinusitis and pneumonia should remain in the differential until further diagnostic work is performed. Supportive care and symptomatic relief should be the initial focus, with further tests conducted if symptoms persist or worsen.
Dr. DiPiero Video Guide to this Case Study
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