Having dry cough, chest pain and on and off fever. What does chest examination suggest?
Patient: hello sir,a 70y/f housewife ,compaints of dry cough 2 months and chest pain(back of th chest) 2 months, history of fever on and from last 2 months and also has a history of weight loss.pet exposure is there. chest examination: B/L decreased air intensity and creapts on the lower part of the chest. x ray chest:a homogenous opacity with air bronchogram on rt middle and lower zones. please tell the dd.thanks Doctor: Thanks for your question on HCM.I can understand your situation and problem.By your symptoms and x ray finding, following are the possible causes.1. Bacterial pneumonia2. Tuberculosis3. Pleural effusion.So better to consult pulmonologist and get done1. Sputum examination for AFB to rule out tuberculosis2. Sputum culture and sensitivity to find out causative organism for pneumonia.3. Ultrasound examination of chest to rule out pleural effusion.4. Bronchoscopy with BAL (Bronchoalveolar lavage) analysis if sputum production is not there.So infective etiology appears more in your case.Better to consult pulmonologist and first diagnose yourself and start appropriate treatment.