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Assembly

Shortness of Breath with History of Cardiac Arrest

Authors
Michelle Bernshteyn, Luke Soelch, Sumendra Joshi
SUNY Upstate Medical University


Case

A 64-year-old male with a past medical history significant for chronic obstructive pulmonary disease, diastolic congestive heart failure, obstructive sleep apnea, and history of cardiac arrest three years prior requiring CPR, presented to the hospital due to shortness of breath. His vital signs on presentation were as follows: blood pressure 120/80 mmHg, heart rate 105 beats per minute, body temperature 37C, respiratory rate of 22 breaths per minute, and oxygen saturation of 89% on room air. His physical examination demonstrated diminished breath sounds diffusely. His clinical presentation and chest x-ray were compatible with pneumonia. This was the patient’s first episode of pneumonia. The patient was subsequently intubated and computed tomography (CT) scan was then performed due to his worsening respiratory status.

Annotated CT
Figure 1
Annotated CT
Figure 2

Question

What is the finding as pointed out by the red arrows?

A. Teratoma
B. Necrotizing fasciitis
C. Chest wall abscess
D. Herniated lung

Answer