An 18-year-old female presents to your urgent care center complaining of sudden-onset, sharp chest pain. She denies any trauma. View the image taken and consider your next steps, along with possible diagnoses.
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Urgent Care Evaluation of Pneumonia
Urgent message: The incidence of community-acquired pneumonia (CAP) is seasonal in nature, with a peak during the winter months and a trough in the summer months. In the urgent care setting, primary concerns are risk factors for CAP, as well as current treatment and testing guidelines. Overview Pneumonia is an acute alveolar lung infection that presents with infiltrates upon chest imaging and is often accompanied by fever, cough, sputum production, shortness of breath, and physical …
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Probe Deeper if Symptoms Just Don’t Add Up
It was a case that easily could have presented in any urgent care center, and one that shows the importance of probing beyond social and medical history, including a patient’s profession and hobbies if necessary. The patient presented with a 7-year history of breathing difficulty that had recently worsened. The only related detail seemed to be that he had been diagnosed with hypersensitivity pneumonitis (HP, also known as farmer’s lung and hot tub lung) 5 …
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Productive Cough and Chills in an Adult
A 37-year-old woman without a significant past medical history presents after 3 days of a cough that produces yellow sputum with some streaks of blood. She has not checked her temperature but says she has “felt warm” and has some chills. She does have associated shortness of breath, but she reports that she has not had chest pain, leg pain or swelling, sweating, or headache. She has a history of hypertension, and she takes an …
Read MoreSudden-Onset Left-Sided Chest Pain
A 32-year-old man with a history of pneumothorax presents to the urgent care after a sudden onset of left-sided chest pain that started 30 minutes earlier when he was inhaling while smoking a cigarette. He reports shortness of breath, dizziness, and diaphoresis. View the image taken (Figure 1) and consider what your diagnosis would be.
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Chronic Cough and Shortness of Breath
A 74-year-old man without a significant past medical history presents to an urgent care center reporting 3 days of coughing productive of green sputum, shortness of breath that worsens with exertion, and chills. He says he has a chronic morning cough but states that the sputum has changed color and that his dyspnea has increased. He says he has not had any fever, chest pain, or lower extremity pain or swelling. View the image taken …
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Eighteen-Year-Old with Cough and Yellow Sputum
An 18-year-old young woman without a significant past medical history presents after 4 days of a cough productive of yellow sputum. Her mother states that her daughter has felt warm to the touch, but she has not checked her temperature with a thermometer. View the radiograph obtained (Figure 1) and consider what your diagnosis would be.
Read MoreClinical Challenge: March, 2015
The Case The patient presented with an upper respiratory infection after vertebroplasty. A chest x-ray was ordered to rule out pneumonia. View the image taken (Figure 1) and consider what your diagnosis would be.
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58-year-old woman with history of bilateral infiltrates
This x-ray was taken on a 58-year-old woman with a history of “recurrent pneumonia” and bilateral infiltrates that did not resolve with antibiotics. View the image taken (Figure 1) and consider what your diagnosis would be.
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