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Fever & Cough

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History: A 24-year-old male presents to the ED with fever, cough and SOB.  He denies any bleeding, chest pain or other complaints.  He has no significant PMH

Exam: Vital signs were normal except for temperature of 102.9.  Physical exam was unremarkable

Initial Concern(s): Bronchitis, pneumonia

Testing: See image BELOW or ABOVE

 

Question(s):

  1. What does the image show (click then click again to enlarge)?  
  2. What should you do next?

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ANSWERS:

  1. The case image shows a retrocardiac infiltrate
  2. What you should do next is to take a lateral x-ray to confirm and treat the patient for pneumonia

Retrocardiac infiltrate seen just above posterior diaphragm

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E-meducation page-shot for educational topic for this case from the 

Tarascon Emergency Department Quick Reference Guide, 2nd edition

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