SELF ASSESSMENT QUESTION

Malaise and fatigue

Young man with progressive weight loss, fevers, and a hilar mass

R T Sadikot¹, J W Christman¹ and A P Milstone²

¹ Center for Lung Research and Division of Allergy, Pulmonary and Critical Care Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee and Department of Veterans Affairs Medical Center, Nashville, Tennessee
² Center for Lung Research and Division of Allergy, Pulmonary and Critical Care Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee

Correspondence to:
Correspondence to:
Professor John W Christman, Vanderbilt University Medical Center, Division of Allergy, Pulmonary and Critical Care, T-1217 Medical Center North Nashville, TN 37232–2650, USA;
John.Christman@mcmail.vanderbilt.edu

Submitted 17 December 2002

Accepted 13 May 2002

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Answers on p 693

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The first 150 words of the full text of this article appear below.

A 27 year old white man with no significant past medical history presented with progressive malaise and fatigue for one month. Two weeks before admission he had developed a cough productive of yellow-green sputum. He had also noted fevers as high as 104.9°F (40.5°C) with chills and rigors. The patient reported unintentional weight loss of approximately 20 pounds (9 kg) over the preceding six months. He worked as a computer technician, had a 10 pack year history of smoking, with modest alcohol intake and no illicit drug use. There was no history of exposure to animals or birds.

On admission he was febrile to 102.1°F (38.9°C) with a pulse of 100 beats/min, blood pressure of 122/66 mm Hg, and a respiratory rate of 20 breaths/min. Oral examination was significant for poor dentition. Chest examination revealed dullness to percussion in the left base and crackles in the right . . . [Full text of this article]

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Young man with progressive weight loss, fevers, and a hilar mass
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