Michael Stillman, MD
Requests for Single Reprints: Michael Stillman, MD, Boston University School of Medicine, 209 Harvard Street, Suite 407, Brookline, MA 02446; e-mail, firstname.lastname@example.org.
Stillman M.; Quite by Chance. Ann Intern Med. 2010;152:192-193. doi: 10.7326/0003-4819-152-3-201002020-00015
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Published: Ann Intern Med. 2010;152(3):192-193.
Last month, a usually vivacious 52-year-old man came to my office for a sick visit. Ten days earlier, during a colleague's funeral, Dave had suddenly become diffusely achy and sweaty. He had gone home feeling a bit weak, had developed a dry cough and low-grade fever, and had spent the weekend in bed. As Dave was generally healthy, he hadn't sought attention for these symptoms, yet when he noted new left-sided pleuritic chest pain, a physician coworker had prescribed a 10-day course of antibiotics for presumed community-acquired pneumonia and asked him to seek formal medical consultation.
On review of systems, Dave stated that he had not had recent fever or rigors and characterized his cough as persistent, productive of nonbloody mucus, and worse when he went to bed. He said that he had not been experiencing shortness of breath, chest pressure, or palpitations and had not needed to sleep on more pillows than usual. He hadn't recently traveled or been exposed to sick people and hadn't been immobilized or sedentary for any extended periods, and although his energy level was a bit low since becoming ill, he had continued to work full-time.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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