A 39-Year-Old Man With Diabetes, Pleuritic Chest Pain, and Multiple Cavitary Lung Nodules

Chest. 2018 Sep;154(3):e69-e72. doi: 10.1016/j.chest.2018.03.035.

Abstract

A 39-year-old male presented to the ED with a 2-day history of fever (Temperature-Maximum 39°C), nonbloody productive cough, and worsening right-sided pleuritic chest pain. The patient denied shortness of breath, nausea, vomiting, sinus symptoms, and abdominal pain. His medical history included type 2 diabetes mellitus (glycated hemoglobin, 11.1), hyperlipidemia, and depression. He smoked marijuana but denied tobacco or illicit drug use. He reported no recent travels. He reported a 1-week history of left molar pain that began after he siphoned stagnant water with a straw from a refrigerator drip pan. He lived in Ohio all of his life. He denied any sick contacts. His medications include Lantus insulin at night, metformin, glimepiride, pravastatin, and Remeron.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anti-Bacterial Agents / therapeutic use
  • Chest Pain
  • Computed Tomography Angiography
  • Diabetes Mellitus, Type 2
  • Diagnosis, Differential
  • Echocardiography
  • Gram-Negative Bacterial Infections / diagnostic imaging*
  • Gram-Negative Bacterial Infections / drug therapy
  • Gram-Negative Bacterial Infections / microbiology*
  • Humans
  • Male
  • Multiple Pulmonary Nodules / diagnostic imaging*
  • Multiple Pulmonary Nodules / drug therapy
  • Multiple Pulmonary Nodules / microbiology*
  • Pleurisy
  • Sphingomonas / isolation & purification*

Substances

  • Anti-Bacterial Agents