Abstract
An 85-year-old African-American man with past medical history significant for hypertension, diabetes mellitus, COPD, remote pulmonary tuberculosis (TB) and lung silicosis, presented with 1 month history of dyspnea, fever, dysphagia and chronic cough with purulent sputum. TB was treated with quadruple therapy 15 years ago and has not had respiratory symptoms since. His occupation for most of his lifetime was construction and demolition. He smoked 1 pack of cigarettes daily for 50 years and quit 10 years ago. Examination of the chest revealed bilateral expiratory wheezing more prominent on the right side with dullness to percussion on the right base. A chest roentgenogram (CXR) showed right lower lobe consolidation suggesting pneumonia. Given his past history of TB …
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