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Page 5 / Case 01.03


ANSWER

Our group suggested the following:
1. continue oral antibiotics for at least 3 more weeks
2. close follow up with repeating the chest radiograph
3. Consider a CT scan of the chest if there is no improvement.

Five days later she started to have a high-grade fever, wet cough, shortness of breath, grunting, and was seen in the emergency of the regional hospital and immediately transferred to our teaching institution.

On admission:
She looked mildly ill.
Temperature 38 c, respiratory rate 50/minute, pulse110/minute, SaO2 97% on room air.

There was neither clubbing nor lymphadenopathy
ENT: normal
CHEST: decreased air entry on the left side, but no adventitial sounds. There was dullness to percussion. The rest of the physical exam was normal.

BELOW IS THE CHEST RADIOGRAPH ON ADMISSION.



Enlarge this chest X-ray, above LEFT, RIGHT.

WHAT IS YOUR INTEPRETATION?


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