bluestar
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A homeless 38 year old man has a 3 month history of decreased appetite, generalized wasting, a low-grade fever, and worsening cough productive of bloody, mucupurulent sputum. He has a 3 year history of alcohol abuse. X-ray fils of the chest show consolidation and cavitary lesion in the apices of the lung. Which diease could it be?
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| Ahab
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TB
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| mash
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tuberculosis
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| Ahab
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Oops double posting
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| bluestar
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were it not a cavity then an most common lung infection of an alcoholic would be Klebsiella, right?
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| mani
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bluestar, how can that explain rest of history: 3 months, wasting etc etc.
i too think its TB
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| dariush
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bluestar Klebsiella causes a severe "Lobar Pneumonia" like Pneumococcus(90%) and occasionally others and if not treated may lead to even severe CAVITATION !!
but obviously not in the Apex which is typical for the 2ndary TB. morever, it is very virulent and doesnt take 3 months to develop and i am not sure but i wouldnt expect LOW-GRADE fever.
TB specially the Resistant forms are now becoming a serious issue among homeless esp immigrants again b/c they go to the med centers and start the tx but since tx for TB should take months (6-9) they dont comply with it and produce resistance in the community.
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| bluestar
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Thank you for the explanation! then where would the cavitation produced by Klebsiella be located normally?
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| mani
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i guess lower lobe, am i rite??
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