Page 151 - JSOM Spring 2020

An Ongoing Series

Explore the Space?

Katarzyna (Kasia) Hampton, MD *; Livia Van Humbeeck, MS-1 2
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hile deployed to a remote FOB, you are the only You note the following vital signs: HR 100 BPM, BP
medically trained provider there. A 50-year-old male 140/85mmHg, RR 24/min, Spo 94% on room air, T 38.2°C
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Wcontractor comes to you complaining of cough and (100.7°F). Your patient looks ill. On clinical examination, you
generalized malaise. He is a smoker and he has been coughing note crackles and focal wheezes in the right middle lung field
for the past month, but he thought it was “allergies and his with diminished breath sounds below that area. You decide to
usual cough.” During the past 2 weeks, his cough has been obtain an ultrasound of the chest.
productive of yellowish sputum, and he has been feeling fever-
ish for 3 days. He also complains of “having pulled a muscle 1. What is the most likely diagnosis?
between his ribs from all that coughing.” He denies any per- 2. What complication has this patient developed, as seen in
tinent past medical or surgical history. He does not take any Figure 1?
medications on daily basis. He mentions a history of seasonal
allergies. Join us on Instagram @sofsono_org for further case discussion.

FIGURE 1 Coronal view of the right pleural space above the diaphragm
(not visualized).

*Correspondence to sofsono.org@gmail.com
1 Dr Hampton is an emergency physician at the US Army Landstuhl Regional Medical Center, Germany, and an expert ultrasound instructor for
the military medical community. Ms Van Humbeeck is a medical student at the Jagiellonian University in Cracow, Poland.
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