Office of Education
Yale University
School of Medicine
367 Cedar Street
300 ESH
New Haven, CT
06519 USA
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Cases | Patient with Fever and Cough
Questions
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What is your most likely diagnosis?
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What host factors unique to this patient places her at risk for such a
diagnosis?
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What features of the history and physical exam support this diagnosis?
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Describe the physical findings
in the chest and what they mean.
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Is the sputum sample helpful in the diagnosis of this patient? What features
of the Gram stain do you look for in evaluating the value of
the sputum sample?
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What kinds of infectious agents can produce this syndrome?
Which would be most common? Which would be most likely in this patient?
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Are there any other diagnostic tests you would order before initiating
therapy?
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What antibiotic(s) would you initiate in this patient empirically?
- Should the patient be hospitalized or could she be treated as an
outpatient?
The patient’s sputum culture grows normal flora. Blood cultures
grow S. pneumoniae that is susceptible to penicillin.
- What would you do now, and how can we prevent this from recurring
again?
Next: Discussion
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