Case Presentation: 66 year old with persistent cough after 3 weeks ago

In keeping with the recent post on pneumonia, here is a case challenge of a patient with a pulmonary process: 66 year old with a history of Parkinsonism, ongoing tobacco dependence developed head congestion, fevers and cough reports to the Emergency Department: History: -3 weeks ago, symptoms began with cough and fevers -2 weeks ago,Continue reading “Case Presentation: 66 year old with persistent cough after 3 weeks ago”

Answer to Case Report: 55 year old with fever and pelvic pain

Answer: Prostatic abscess (left lobe) secondary to Staphylococcus aureus Question 1: The CT scan demonstrates evidence of swelling of the left lobe of the prostate with what appears to be an early ring-enhancing focus, probable abscess. Question 2: 6/6 blood cultures positive. The Gram stain is consistent with Gram positive cocci in clusters. This isContinue reading “Answer to Case Report: 55 year old with fever and pelvic pain”

Case Report: 55 year old man with fever and pelvic pain

History of Presenting Illness: 55 year old man with insulin-requiring diabetes mellitus and diabetic polyneuropathy with right foot ulcer presents to the Emergency Department with pain in the suprapubic area radiating into the rectum and shaking chills. He went in a river to fish 4 weeks ago and developed a blister around his diabetic ulcer;Continue reading “Case Report: 55 year old man with fever and pelvic pain”

Answer to Questions: 51 year old man with worsening pneumonia while hospitalized

Question 1: What is being shown on CT scan? The CXR is showing what appears to be air-fluid levels in the right pleural area on the radiograph and is confirmed on the CT scan with fluid and air within the right pleural space. The lung parenchyma of the left base appears to show significant bullousContinue reading “Answer to Questions: 51 year old man with worsening pneumonia while hospitalized”

Case Report: 51 year old man with worsening pneumonia while hospitalized

History 51 yo with increasing shortness of breath, cough and weakness over a period of a few weeks. No previous significant past medical history Low grade fever Works as a custodian and was subjected to a lot of second-hand smoke His initial CXR: Hospital Course Initially placed on Rocephin, Levaquin and Doxycycline Started on SolumedrolContinue reading “Case Report: 51 year old man with worsening pneumonia while hospitalized”

Case Report: An Incidental Finding

What structures are visualized on the H & E stains? The structures are subtle but relate to non-caseating granulomas found in the colonic mucosa What is the special stain that was used and what is shown? The stain is known as a FITE stain which stains the bacterial cell wall of Mycobacteria species, which haveContinue reading “Case Report: An Incidental Finding”

Case Report: An Incidental Finding

A 62 year old Filipino male is referred to a gastroenterologist by his primary care physician for a screening colonoscopy for colon cancer. He reports no major complaints to the GI doctor, including no fevers, chills sweats. Review of systems: There has been no diarrhea, no weight loss, no blood in stool, constipation, change inContinue reading “Case Report: An Incidental Finding”

Case Report: 18 year old with increasing neck mass

Answer: Neck abscess caused by Fusobacterium necrophorum The patient was found to have an abscess on CT scan 4.7cm x3.8cm x 9cm. Initially mass was aspirated with 10cc of foul-smelling purulence removed. The Gram stain revealed Gram negative bacilli. The patient was brought to OR for incision and drainage. She was left on approximately 3-4Continue reading “Case Report: 18 year old with increasing neck mass”

Case Report: 18 Year Old With Increasing Neck Mass

History of Present Illness: 18 year old female presents with a worsening neck mass over the last few weeks.  Three weeks weeks ago, she reports initially having fevers, aches, chills and severe sore throat. One week ago, she was seen in the clinic for sore throat and neck swelling and had a Monospot test whichContinue reading “Case Report: 18 Year Old With Increasing Neck Mass”

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