Persistent Cough and Hoarseness in Young Adult with Smoking History

Case at a Glance

A 25-year-old male presents with a 2-week history of hoarse voice and dry, unproductive cough with occasional chest pain. Patient has a significant smoking history including daily marijuana use for 7 years and intermittent vaping for 5 years.

Patient's Story

The patient reports developing hoarseness described as sounding like 'the morning after a night spent screaming' along with a persistent dry cough over the past two weeks. He experiences occasional sharp chest pains associated with the cough. Notably absent are other upper respiratory symptoms such as rhinorrhea, nasal congestion, or fever. The patient has been smoking marijuana daily since age 18 and has used vaping products on and off since age 20. He expresses concern about lung cancer and is motivated to quit smoking.

Initial Assessment

Physical examination pending. Patient appears otherwise well with isolated respiratory symptoms of hoarseness and non-productive cough. No systemic symptoms reported. Given the patient's young age and symptom duration, viral upper respiratory infection is most likely, though the smoking history warrants careful evaluation.

The Diagnostic Journey

Initial consultation with oncology specialist suggested viral etiology as most probable cause. Patient advised to monitor symptoms with follow-up if cough persists beyond one week total duration. Differential diagnosis includes viral laryngitis, smoking-related irritation, or less likely malignancy given patient's age.

Final Diagnosis

Likely viral upper respiratory tract infection with laryngeal involvement. Smoking cessation counseling provided.

Treatment Plan

Conservative management with symptom monitoring. Patient counseled on smoking cessation for both marijuana and vaping products. Follow-up recommended if symptoms persist beyond one week from initial onset or if new concerning symptoms develop.

Outcome and Follow-up

Patient motivated to quit smoking habits. Advised to seek medical attention if cough persists or worsens, or if additional symptoms develop. Long-term follow-up will focus on smoking cessation support and respiratory health monitoring.