Dx Challenge: Teen athlete with chest pain, cough, and dyspnea.

A 16-year-old high school athlete presented to the emergency department with complaints of chest pain, cough, and dyspnea that developed that same day. The patient had no significant medical history and was not currently taking medications. He denied tobacco or electronic cigarettes and illicit drug use. There was no recent history of travel or trauma. He had no known allergies. On physical examination, tachycardia, chest retractions, and decreased breath sounds on the right side were present. What’s the diagnosis?

A)     Acute chest syndrome

B)     Anaphylaxis

C)     Spontaneous pneumothorax

D)     Tension pneumothorax

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