these are actual cases to –stimulate your reading –test your knowledge of the material look for...
TRANSCRIPT
• These are actual cases to– Stimulate your reading– Test your knowledge of the material
• Look for the sound icon
• 25 year old male• 2 to 3 weeks of gradually
worsening productive cough• minimal improvement with
Levofloxacin• went to ER• nonsmoker• PMHx unremarkable
• Physical Exam: VSS, no adenopathy. Resp – coarse breath sounds right lung, no clubbing. Cardiac, neurologic, abdominal exam unremarkable.
• Bloodwork – leukocytosis and mild bandemia
• Q1: Interpret the CXR.• Answer (Q1)
• Q2: Based on the clinical and radiographic information provided, what are the diagnostic possibilities and your most likely diagnosis?
• Answer next slide
Lung Cavity
Lung Abscess Cavitating Malignancy
VasculitisMets to the lungSeptic emboli
Usually seen with multiple cavities
Answer (Q2)
• Certain gram positive cocci, gram negative bacilli, anaerobes
• TB, fungus
• Squamous cell
• Adenocarcinoma
• Q3: How would you manage this patient?• Answer (Q3)
• After 3 weeks of antibiotics, the patient has minimal symptomatic improvement.
• CXR – no change
• Q4: How would you manage the patient lacking symptomatic or radiographic improvement?
• Answer on next slide