This is a case of a 19-year-old male patient presenting with acute cough, high fever, and dyspnea. Other than a resolved seizure episode, he had no previous medical history. He had been taking montelukast and trimethoprim-sulfamethoxazole before admission. Animal exposures to a new puppy and a friend's bird were noted. His paternal grandmother had rheumatoid arthritis.
CASE PRESENTATION: A 19-year-old, previously healthy man presented with 3 days of cough, high-grade fevers (40 degrees C), and dyspnea. Apart from a resolved history of seizures not requiring medications, he had no medical or surgical history. He had no known drug allergies. He took montelukast for allergies and trimethoprim-sulfamethoxazole (TMP-SMX) for 2 weeks before admission for acne, but no other medications, including over-the-counter medications and supplements. He had animal exposures to a new puppy and a friend's bird. He had no history of smoking, vaping, or recreational drug use. His paternal grandmother had rheumatoid arthritis.
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