MKSAP: 45-year-old man with cough and right-sided chest discomfort

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 45-year-old man is evaluated for right-sided chest discomfort and cough of 2 weeks’ duration. His chest discomfort is described as a vague, painful sensation on the right. The cough occasionally produces a small amount of sputum; he reports no hemoptysis or shortness of breath. He has felt feverish with mild fatigue but has had no weight loss. He is a smoker with a 20-pack-year history. He takes no medications. On physical examination, temperature is 37.6 °C (99.7 °F), blood pressure is 130/70 mm Hg, pulse rate is 86/min, and respiration rate is 18/min. BMI is 27. Oxygen saturation breathing ambient air is 98%. Chest examination is normal, and the remainder of the physical examination is unremarkable. No skin rash is present. Chest radiograph shows a nodule in the right lower lung lobe, which CT of the chest confirms. CT-guided biopsy of the nodule is performed. Findings on histologic testing are positive for budding yeast, and culture indicates Cryptococcus neoformans. An HIV test result is negative. Which of the following is the most appropriate management? A: Caspofungin B: Lumbar puncture C: Surgical removal of the nodule D: Clinical observation Continue reading ... Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how.
Source: Kevin, M.D. - Medical Weblog - Category: Journals (General) Authors: Tags: Conditions Infectious disease Source Type: blogs

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CONCLUSIONS: Xyloglucan/gelose plus ORS was effective and safe in treating acute diarrhea in children. PMID: 33028102 [PubMed - as supplied by publisher]
Source: Expert Review of Gastroenterology and Hepatology - Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research
Publication date: Available online 8 October 2020Source: Pulmonary Pharmacology &TherapeuticsAuthor(s): Noriyuki Ohkura, Masaki Fujimura, Johsuke Hara, Yusuke Nakade, Miki Abo, Takashi Sone, Hideharu Kimura, Kazuo Kasahara
Source: Pulmonary Pharmacology and Therapeutics - Category: Respiratory Medicine Source Type: research
COVID symptoms include a high fever, a new cough, and loss of smell and taste - all of which require the UK public to get a free coronavirus test as cases continue to rise. But you may be at risk of deadly COVID-19 complications if you develop "white patches" of jelly in the lungs, scientists have revealed.
Source: Daily Express - Health - Category: Consumer Health News Source Type: news
Rationale: Bronchopleural fistula (BPF) is a dreaded complication after lobectomy or pneumonectomy and is associated with high morbidity and mortality. Successful management remains challenging when this condition is combined with empyema, and the initial treatment is usually conservative and endoscopic, but operative intervention may be required in refractory cases. Patient concerns: Two patients diagnosed with BPF with empyema were selected to undergo surgery in our hospital because they could not be cured by conservative and endoscopic therapy for 1 or more years. One was a 70-year-old man who had a 1-year history ...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
The outbreak of Coronavirus disease 2019 (COVID-19) has been widely reported to cause symptoms such as fever, cough, sore throat, fatigue and shortness of breath. Neurological complications have not been widely reported without associated respiratory symptoms. These neurological manifestations have been found mostly in the elderly1. There has been no report of ataxia or COVID-19 cerebellitis in the young adult population without associated respiratory symptoms.
Source: The Journal of Emergency Medicine - Category: Emergency Medicine Authors: Tags: Selected Topics: Neurological Emergencies Source Type: research
We report the first confirmed case of the novel coronavirus disease (COVID-19) in a lactating patient in Chizhou, Anhui Province, China. The lactating patient presented with intermittent fever for 16  days and cough for 10 days. Given her travel history to the epidemic area and the chest CT scan results, the patient was immediately admitted to the isolation ward of the Infectious Disease Department and breastfeeding was discontinued. Pharyngeal swab specimens tested positive for severe acute r espiratory syndrome coronavirus 2 (SARS-CoV-2, previously known as 2019-nCoV) in nucleic acid testing. During hospitaliza...
Source: Infection - Category: Infectious Diseases Source Type: research
AbstractObjectivesWe investigate the effects of Ginger, compared to the usual therapeutic regimen on clinical manifestations and paraclinical features in patients with confirmed COVID-19 that are moderately ill.Trial designThis is a single center, randomized, double-blind, placebo-controlled clinical trial with parallel group design.ParticipantsInclusion criteria:1. Patients admitted to Severe Acute Respiratory Syndrome (SARS) Departments at Shahid Mohammadi Hospital, Bandar Abbas, Iran2. Age ≥18 years (weight ≥35 kg)3. Hospitalized ≤48 hours4. Confirmed SARS-CoV-2 diagnosis (Positive polymerase chain reaction (PC...
Source: Trials - Category: Research Source Type: clinical trials
Most prevalent first symptoms cough, sore throat, body aches, fever for those testing positive for SARS - CoV - 2
Source: Pulmonary Medicine News - Doctors Lounge - Category: Respiratory Medicine Tags: Family Medicine, Gynecology, Infections, Internal Medicine, Nursing, Pulmonology, Journal, Source Type: news
COVID symptoms include a high fever, a new cough, and loss of smell and taste - all of which require the UK public to get a free coronavirus test. But you may also be at risk of COVID-19 if you develop an eruptive skin rash; and it may be the only symptom you develop. Should you consider self-isolating?
Source: Daily Express - Health - Category: Consumer Health News Source Type: news
Persistent coughing in children is always a challenge, both for parents trying to describe and measure the cough, and for doctors making a diagnosis. In the current climate, this is all the more difficult, seeing as a continual cough is one of the major symptoms of COVID-19. UK Government guidance advises that anyone with a persistent cough should get a coronavirus test. But with the reopening of schools and the beginning of the cold&flu season both coinciding with a national shortage of tests available, should we all err on the side of caution and try to get a test at the first sign of a cough or sniffle, or can the d...
Source: The BMJ Podcast - Category: General Medicine Authors: Source Type: podcasts
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