Case [Image] courtesy of Dr Aditya Shetty, <a href="https://radiopaedia.org/">Radiopaedia.org</a>. From the case <a href="https://radiopaedia.org/cases/27747">rID: 27747</a>

Treat the Sneak Peek

The correct diagnosis of the module below will be the topic of our September 5th and September 18th  Podcasts.

Chest X-Ray

A 45 year old male presents with a cough.


HISTORY:

HPI: 45 yo M presents with 1 week of debilitating cough and nocturnal sweating.  He was briefly incarcerated until he was released four weeks ago, then developed a severe productive cough with reddish brown sputum one week later. This was accompanied by a recent weight loss of about 15 pounds over the past few weeks, and waking up sweating almost every night. He currently doesn't feel feverish and denies chest pain, shortness of breath, abdominal pain, or ever experiencing these symptoms before.


PMH: No previous history of hospitalizations or surgeries.

Medications: None

Family Hx: No relevant family history

Social Hx: Usually drinks 5-8 drinks each weekend. 20 pack-year history of smoking. History of IV drug use. Sexually active with multiple female partners. 

​Allergies: NKDA


ROS: Negative except noted above.


EXAMINATION:


Temperature: 38.2°C (100.8°F)
HR: 81 bpm
RR: 18/min

SpO2: 94% on room air


HEENT: An enlarged, painless, soft left cervical lymph node is noted.


CV: Regular rate and rhythm, S1 and S2 intact, no murmurs, rubs, or gallops


Lungs: Crackles heard in the right lower lung field.