Page 2 / Case 04.03
Striking asymmetry of hemithoraces, with diffuse, homogeneous appearing opacity of almost the entire right side, and loss of the right heart border. The right diaphragm is evident, though the sharpness of the costophrenic angle is difficult to ascertain. There is little to no shift of the mediastinum, and the cardiothymic silhouette (the portion that can be seen) appears normal. There are no collections of extrapleural air, as pulmonary markings can be seen out to the periphery on the left. Situs appears normal, with the gastric bubble on the left.
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ANSWER
Striking asymmetry of hemithoraces, with diffuse, homogeneous appearing opacity of almost the entire right side, and loss of the right heart border. The right diaphragm is evident, though the sharpness of the costophrenic angle is difficult to ascertain. There is little to no shift of the mediastinum, and the cardiothymic silhouette (the portion that can be seen) appears normal. There are no collections of extrapleural air, as pulmonary markings can be seen out to the periphery on the left. Situs appears normal, with the gastric bubble on the left.
Below is a picture of his rash:
Enlarge
the image, TOP
LEFT, TOP
RIGHT.
Note that it is unilateral with a sharp, well-defined border, and papular
in appearance.
CAN
YOU GIVE A DIFFERENTAIL DIAGNOSIS BASED ON THE INFORMATION GIVEN UP
TO THIS POINT?
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