Chest
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Selection of empiric antibiotic treatment for community-acquired pneumonia (CAP) that is concordant with clinical practice guidelines has been associated with improved short-term outcomes of this infection, but whether it is also associated with longer-term outcomes is unknown. ⋯ Use of guideline-concordant antibiotic therapy for CAP treatment in older hospitalized patients is associated with a significant reduction in the risk of cardiovascular death at 1 year post-CAP. This finding further supports current clinical practice guideline recommendations for CAP treatment.
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A 56-year-old Chinese man, who did not smoke, presented with a 2-month history of cough and bloody sputum. He also complained of fatigue, night sweats, chest pain, and shortness of breath, with no chills or loss of weight. He previously worked as a veterinarian and had been infected with Brucella 30 years ago. ⋯ The results of the purified protein derivative skin test and interferon-gamma release assay for TB were negative. Brucella agglutination test was also negative. On the night of admission, the patient coughed up two silver-white-colored shiny stones and had a fever of up to 38.5 °C on the following days.
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Comment Case Reports
Potassium Chloride-Induced Phlebitis via a Malpositioned Central Venous Catheter.
We present a case of potassium chloride-induced phlebitis with severe, burning, left-sided chest pain when infused via a malpositioned central venous catheter. Using a malpositioned central venous catheter requires careful consideration, but this novel case prompts the need for additional review before its use for the infusion of potentially irritating medications.
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A 75-year-old man presented to our hospital with cough and sputum for more than a year. Eight months previously, the patient was admitted to a local hospital, and his symptoms were relieved after symptomatic treatment (expectorants and antitussives). ⋯ The patient had no history of genetic disorders or cancer. He did not present with fever, dyspnea, hemoptysis or chest distress, and there was no history of weight loss since onset.
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A 40-year-old man with no significant medical history presented to the ED with a 2-day history of right-sided chest pain accompanied by night sweats and chills. These symptoms were accompanied by a dry, nonproductive cough without hemoptysis. The patient worked as an air traffic controller, with a side business of buying, renovating, and selling houses. ⋯ A resident of Platte City, Missouri, he had recently traveled to Salt Lake City, Utah. At the time of presentation, the patient denied any fever or shortness of breath. He had no history of nicotine, alcohol, or illicit substance use and denied any recent weight loss.