An old-age farmer with chronic dyspnea

Abstract

A 94-year-old man, known case of chronic lymphocytic leukemia and chronic lung disease, presented to the Emergency Department with aggravation of his chronic dyspnea and non-productive cough since about 2 weeks prior to hospitalization. He had no complaint of fever or chest pain. At the time of hospital admission, the patient was tachypneic (respiratory rate of 22 breaths/minute), tachycardic (pulse rate of 110 beats/minute), normotensive, and afebrile. His-physical examination was also significant for a decreased breath sound in lower part of right lung field – with a dull percussion -, fine bibasilar crackles, mild and diffuse wheeze, and bilateral lower extremities pitting edema up to the level of calves.