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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.
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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
Answer (Q2) Lung Cavity Usually seen with multiple cavities Lung Abscess Cavitating Malignancy • Certain gram positive cocci, gram negative bacilli, anaerobes • TB, fungus • Squamous cell • Adenocarcinoma Vasculitis Mets to the lung Septic emboli
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