58 y.o. man was at his summer cottage outside St-Petersburg in the begining of February 2014. He was doing some home reconstraction work when suddenly developed a general fatigue and dyspnea during minimal physical excercises. Next day he developed a fever up to 39C and he was hardly able to drive back to St-Petersburg by his car. He went directly to his family physician whe had reffered him to infectious disease hospital with pneumonia. At addmission department in inf dis hospital his breathe rate was 24-26 per minute at rest, heart beat rate 110-120 per minute on minimal phisical activity. BP 140/90 mmHg, fever 39C. He told his doctor that there were a mouses in his summer cottage but refused having pain in calf muscles and dicrease urine volume. Xray was performed and patient was sent to department for acute respiratory viral infection thought he refused having any respiratory symptoms except dyspnea. He was treated with 2 gr of IV ceftriaxone with 0,5 gr clarythromycin bid per os and tamiflu 75 mg bid for seven days with no effect - fever and dyspnea persisted and Xray was repeated. CBC, urine analysis and biochemistry profile didnt reveal any abnormalities. What is a diagnosis, which test or examination you want to have and what type of changes you can see on Xray?
Posted on: Sat, 12 Apr 2014 17:12:41 +0000