Clinical Images
Body-wide Pain
A 43 year old man presented to the Emergency Department with a chief complaint of body-wide pain. He reported a productive cough for three days, fever, shortness of breath, and nasal drainage. His past medical history was significant for coronary artery disease with four cardiac stents placed, hypertension, hyperlipidemia, and type 2 diabetes. He smokes tobacco, drinks alcohol, and uses recreational IV drugs.
Initial vital signs were significant for a temperature of 39.2, heart rate of 134, blood pressure of 142/95. The patient was uncomfortable and ill-appearing, but awake and alert. Physical exam revealed dry mucous membranes. Lung sounds were normal, and cardiac exam showed tachycardia and no murmur. Laboratory data was significant for a white blood cell count of 18.3 and a creatinine of 2.60.
AP and lateral views of his chest x-ray are shown here.
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References
1. Gordon, RJ, Lowy, FD. Bacterial Infections in Drug Users. N Engl J Med 2005; 353:1945-1954. Nov.
Author Bio:
Rosie Lehmann is a third year Emergency Medicine resident at Christiana Care Health System in Newark, DE. She attended the University of Rochester School of Medicine, and currently lives in West Chester, PA with her husband and 1 year old twins.