Patient Presentation and Initial Symptoms

A 60-year-old female presented in the emergency department with a persistent, non-productive cough and fatigue lasting three months, which began after a flu-like illness. She reported recurrent syncope, weakness, and loss of appetite, along with a significant weight loss of six kilograms. The initial evaluation revealed no fever or shortness of breath, but her medical history included hypothyroidism post-thyroidectomy and previous right ureteral stones. Urinalysis indicated potential kidney issues, prompting further investigation into her pulmonary and systemic symptoms.