January critical care case of the month: bad cough

Abstract

No abstract available. Article truncated after 150 words. History of Present Illness A 41 year-old man was admitted with a five-day history of cough, shortness of breath, and fever to 102° F. He was recently diagnosed with a high-grade astrocytoma of the brain and had undergone resection followed by chemotherapy with temozomide (an alkylating agent) and radiation therapy. PMH Renal transplantation (1993) Glioblastoma (astrocytoma grade 4) Crohn’s disease treated with budesonide and meselamine Medications Dexamethasone 2 mg PO BID Keppra 500 mg PO BID Tacrolimus 1.5 mg PO AM and 1mg PO PM Mycophenolate 750 mg PO BID Budesonide 3 mg PO daily Meselamine 1600 mg PO TID Sulfamethoxazole/trimethoprim DS PO on Mon/Wed/Fri Temozolomide 75 mg IM with radiotherapy Social History Nonsmoker, no ethanol or recreational drugs, no recent travel, and no occupational exposures. Physical Examination T 38.6°C, P 112 beats/min, RR 32-40 breaths/min, BP 119/76 mm Hg, SpO2 100% on NRB General: Fatigued, ill appearing and dyspneic. …

Keywords

• coccidioidomycosis
• valley fever
• thrombocytopenia
• immunocompromised host
• pneumonia
• nodules
• miliary
• acidosis
• metabolic acidosis
• anion gap