A 43 year-old white male with a history of hypertension and a smoking history of 30 pack-years presented to the emergency room coplaining of cough, severe dyspnea, nausea, and vomiting. Ten days prior to presentation, he experienced flu-like symptoms with a low-grade fever, myalgias, and malaise that lasted approximately four days but resolved spontaneously. He had a cough productive of white sputum and blood-tinged nasal drainage for one week. Three days prior to presentation he began to experience right upper quadrant abdominal pain and bilious vomiting. The patient worked as a bar inspector and had a routine PPD check 9 months prior to presentation which was negative. However, his daughter did have a recent positive screening PPD with a negative chest x-ray.
Mellinger Kohl, Traci and Cartwright, Elizabeth
"Severe Dyspnea and Cough,"
The Medicine Forum:
Vol. 3, Article 6.
Available at: http://jdc.jefferson.edu/tmf/vol3/iss1/6