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Week 25

 

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Quiz 25 Context:

A 34-year-old male presents with complaints of nausea, malaise, and fatigue. The duration of these symptoms is difficult to determine; initially he complained of chronic low grade fevers and cough; subsequently constitutional symptoms have developed and they seem to have been present to some degree for several months but have clearly worsened over the past weeks. The patient has spent most of his life in sub-Saharan Africa and is visiting relatives in the United States. The patient has not had regular medical care, however history is reportedly negative for known chronic conditions.

Physical examination reveals a male patient in no acute distress. Vital signs reveal a temperature of 37.8 degrees Celsius, heart rate 68 bpm, blood pressure 126/68 mmHg. The exam is most notable for jugular venous distension, Kussmaul's sign, abdominal ascites, and 1+ peripheral edema.

A chest radiograph is done and is shown above.

This history, examination, and chest film are most consistent with which of the following possibilities:

  1. Churg-Strauss syndrome
  2. Sarcoidosis
  3. Toxic shock syndrome
  4. Constrictive pericarditis
  5. Aspergillosis

 

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Center for Continuing Education | 9500 Euclid Avenue, KK31, Cleveland, OH 44195