A persistent dry cough and an incidental finding

A 25-year-old woman presented to the urgent care clinic with a .3 to 4-week history of dry cough that is worsened when \he was lying supine. The patient said the cough had worsened over the past 1 to;2 weeks with spasmodic episodes or nighttime couching (hat caused her to occasionally vomit. Other symptoms included mild nasal congestion and subjective fever for several nights, but no chills, night sweats, or wheezing. She had a history of seasonal allergies. Over-the-counter cough and cold medications provided no relief of symptoms.