Extract
A 68-year-old male patient, who was an ex-smoker of 20 cigarettes a day and a retired welder, presented to his general practitioner with a 4-day history of sweats, significant weight loss of almost 13 kg, no appetite and feeling tired, with a productive cough, phlegm and significant haemoptysis. His past medical history included an 8-year history of chronic obstructive pulmonary disease (COPD), 60 years of asthma, tuberculosis (TB) diagnosed and treated in 1974, a 15-year history of anxiety, a 16-year history of herpes zoster, and excision of a lesion from the facial bone in 2002 for a suspected melanoma. His medications included a salmeterol inhaler (Seretide 500BD; GlaxoSmithKline, Brentford, UK), tiotropium, amiodarone, carbocisteine, omeprazole and simvastatin, and due to his recurrent chest infections, he was treated with appropriate courses of antibiotics.
Abstract
The cause of this patient’s symptoms is not what it seems. Can you diagnose him?
http://ow.ly/s67F30eOeaO
Acknowledgements
We would like to thank Navin Boniface Matthias and Alistair William Forrester (Hairmyres Hospital, Glasgow, UK) for all their valuable input and excellent work.
Footnotes
Conflict of interest None declared.
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