d_raza1
Forum Senior
Topics: 32
Posts: 92
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A 21-year-old man comes to the clinic because he has become increasingly short of breath and has had a cough for the past week.
He appears dyspneic and has a temperature of 38.3EC (101.0EF). On physical examination he has bibasilar rales and generalized
lymphadenopathy (1 to 2 cm). Rectal examination shows multiple perianal contusions and a small amount of blood oozing from the
anal orifice. Chest x-ray film shows bilateral patchy alveolar infiltrates. The most appropriate course of action is to order blood tests
,Admit him to the hospital and begin administration of trimethoprim-sulfamethoxazole, intravenously
so wht is the diagnosis?
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| saadtazjam
Forum Elite
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Pneumocystis carini pneumonia?HIV
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| d_raza1
Forum Senior
Topics: 32
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so oozing blood from anus is perhaps due to thrombocytopenia?
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| Sea_gull
Forum Elite
Topics: 32
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Perianal contusion ??????????
Contusion is a mechanical injury causing extravasation of blood beneath the skin.
No disease process can lead to "contusion " except hitting
Is this a "home made" question ???
GL
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| MDcooper
Forum Guru
Topics: 211
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BL infiltrates are seen with mycoplasma,legionella,viruses and PCP.trimethoprim ans sulfmethoxazole is treatment for PCP pneumonias..I think the perianal contusions is pointing towards the man being homosexual and aquiring HIV infection. although he is extremly sick and I wonder if the reason for the contusions is recent sexual contact!(and it is extremly embaressing if I am wrong as I hate to be monotonous about a SINGLE issue.Plz dont get me wrong).
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| d_raza1
Forum Senior
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IT IS NOT HOME MADE QUESTION, IT WAS FROM SOME AUTHENTIC USMLE SITE.
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| Sea_gull
Forum Elite
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If this is not home made then what is the cause of this " perianal contusion"?????????
GL
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| study_ing
Forum Fanatic
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he's a homosexual as Md cooper pointed out. and d-raza, please label ur q BNBME if it one.
HIV and PCP pneumonia wud be my answer too.
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| cbenitesch
Forum Senior
Topics: 10
Posts: 141
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I think contussion is related to homosexual behavior (and if itīs a home made question we need just to get the main idea and assume we are doing the test! This is the main reason of this forum). Iīll go for HIV infection and Pneumocistis jirovecci infection.
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