Book of PDFs-5000 Clinical Case Puzzlers Part II

5000 Clinical Case Puzzlers Part II

Pdf Summary

This article discusses two cases of pulmonary infections and provides clinical approach guidelines for diagnosing and managing such infections. The first case involves a 39-year-old male with a history of smoking and end-stage renal disease. He presents with fevers, chest pain, and lower quadrant pain. The patient's laboratory and radiology findings lead to a diagnosis of angioinvasive mucormycosis. The article emphasizes the importance of recognizing uncommon manifestations of common diseases. Treatment for mucormycosis involves surgical debridement and IV Amphotericin B.<br /><br />The second case involves a 31-year-old male from India who is asymptomatic but has abnormal imaging findings. Further investigations reveal a cyst in the left upper and left lower lung. This is diagnosed as pulmonary echinococcosis, which is commonly discovered incidentally but can have serious consequences if the cyst ruptures. Treatment involves complete surgical removal and prolonged anti-helminthic treatment.<br /><br />The article provides clinical pearls for approaching patients with pulmonary infections, including the importance of the patient's history, physical examination, location of infection, and extrapulmonary examination. It also emphasizes the use of old chest X-rays in diagnosis. The article concludes with lessons learned from the cases, such as the fact that mucor prefers an acidic environment and the need to consider echinococcosis in patients with appropriate history.

Keywords

pulmonary infections

clinical approach guidelines

diagnosing

managing

angioinvasive mucormycosis

uncommon manifestations

surgical debridement

IV Amphotericin B

pulmonary echinococcosis

complete surgical removal