Case 4

 

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Case Description


  • A 47 year-old male with a history smoking is
    seen at an internal medicine clinic

  •   Chief Complaint/History:

    •  Cough productive of
      reddish yellow sputum with right-sided chest pain
      on inspiration for the past two days

    • Fever

    •  Chills

    • Nocturnal sweating which
      drenches that bed clothes

  • Physical Exam:

    • Well-developed,well-nourished male

    • Temperature: 39

    • BP: 140/90 mm Hg

    • Pulse: 90

    •  Lungs-dullness to percussion at the R base with rales and ergophony

    • Cardiovascular:-regular rate and rhythm

    • Abdomen-normal

  •  Laboratory:

    • Chest x-ray-RLL
      infiltrate

    • White blood
      cell-14.2K/ml.

   aspiration      lung cancer      pneumonia   
The differential diagnosis: (1) , (2) with post-obstructive pneumonia, (3) .