January 2017 critical care case of the month

Abstract

No abstract available. Article truncated at 150 words. History of Present Illness: The patient is a 48-year-old man who presented with two days of progressive shortness of breath and non-productive cough. There were no associated symptoms and the patient specifically denied fever, chills, night sweats, myalgia or other evidence of viral prodrome. He had no chest pain or tightness, nausea, vomiting, or leg swelling and he could lay flat. He had no recent travel or sick contacts and was Influenza-immunized this season. Past Medical History: Hypertension; Hyperlipidemia; Type 2 diabetes mellitus with a recent hemoglobin A1C of 11%. Social History: Cook at pizzeria; Gay and lives at home with roommate of several years; Smokes marijuana weekly; Prior history of cocaine use. Family History: Noncontributory. Physical Examination: Vitals: T 99.1º F / HR 125 / BP 193/93 / RR 24 / SpO2 88%; General: Tachypneic. Alert and oriented X 4. Lungs: Crackles at bases bilaterally, no wheezes. Heart: tachycardia