Chapter

Case 33

John Stradling, Andrew Stanton, Najib Rahman, Annabel Nickol and Helen Davies

in Oxford Case Histories in Respiratory Medicine

Published on behalf of Oxford University Press

Published in print July 2010 | ISBN: 9780199556373
Published online November 2012 | e-ISBN: 9780191753299 | DOI: http://dx.doi.org/10.1093/med/9780199556373.003.033

Series: Oxford Case Histories

Case 33

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A 71-year-old lady was referred to the respiratory clinic with a history of non-resolving pneumonia. She had presented to her GP 3 weeks previously with cough, fevers and myalgia, and despite courses of amoxicillin and erythromycin, she was not improving. On direct questioning, there was a 3-month history of progressive dyspnoea and a dry cough. She had been seen by her GP four times over the last 6 months and treated with antibiotics for chest infections on each occasion.

Her past history included controlled epilepsy, and bilateral knee replacements for osteoarthritis several years ago. She was a lifelong non-smoker with pigeons living in her roof space, but with no other personal or family history of note. Her current medication included phenytoin, paracetamol and diclofenac.

On examination she was sweaty, although afebrile. She was tachypnoeic (22/min) at rest, her oxygen saturations were 93% and on examination of the chest she had bilateral fine crackles at the bases with no other signs of cardiac decompensation.

Chapter.  2008 words.  Illustrated.

Subjects: Respiratory Medicine and Pulmonology

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