S2D: The Symptom to Diagnosis Podcast Cough, Fever and Respiratory Complaints
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Feb 10, 2021 The podcast discusses diagnosing cough, fever, and respiratory issues, covering differential diagnoses for pneumonia, a case of pneumocystis pneumonia in an HIV-positive patient, fever in the elderly, detailed history in respiratory complaints, and the importance of thoracentesis in pneumonia.
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Elderly Patient With Subacute Respiratory Illness
- A 72-year-old man presented with 10 days of cough, low-grade fevers, worsening dyspnea, and 92% oxygen saturation.
- Exam showed diffuse crackles and low-grade fever prompting further imaging and workup.
Unexpected PCP Diagnosis In Older Man
- Chest x-ray showed bilateral diffuse infiltrates; urinary Legionella antigen was negative but HIV testing returned positive with CD4 120.
- Bronchoscopy confirmed pneumocystis pneumonia and the patient improved on Bactrim plus steroids.
Use Chest X-Ray To Confirm Pneumonia
- Get a chest x-ray when you suspect pneumonia rather than relying on WBC or other labs.
- Order imaging for fever, shortness of breath, abnormal lung exam, hypoxia, or high-risk patients.