Phone Visit
Narrative: SPRUCE MESSAGE VISIT Date: 2026-09-01 Encounter: Spruce text message CC: Persistent dry hacking cough for approximately 10 days, worse at night and in the morning. HPI: Dominic has had a hacking dry cough for approximately 10 days with no fever noted throughout the illness. The cough is elevated at night and in the morning, and he took an unusual nap the day prior to the message. There is no runny nose, no history of similar cough, and no family history of asthma. Parents have been giving honey at bedtime; he coughs a lot at bedtime but is able to fall asleep. The cough has neither improved nor worsened over the 10-day period. Assessment: Likely a self-limiting viral illness with a prolonged cough phase, given the absence of fever, no worsening trend, no history of asthma, and symptom pattern consistent with a 10–14 day course of mild respiratory illness. Plan: Watchful waiting recommended for the remainder of the week to allow symptoms to resolve naturally. In-person visit scheduled for the following week to reassess the cough and conduct Dominic's annual well-child checkup with up-to-date vaccinations. Key clinical quotes: "If this plan makes sense, let's give it the rest of this week and see if the cough settles, often it's a 10-14 day adventure of mild symptoms before they start improving." "does he have any history of cough like this, any family of asthma?" "is it improving at all, any fever at all over the 10 days?" Source: Spruce conversation t_2Q33UE3IVP000