Case 49-1990

Presentation of CaseA 47-year-old man was admitted to the hospital because of fever and pleuritic chest pain.The patient was in excellent health until one week earlier, when he awoke in the morning with severe pain in the left posterolateral aspect of the neck that moved to the left anterior thorax by late in the afternoon; the pain was exacerbated by deep inspiration and was accompanied by mild dyspnea.Four days before entry fever developed, and the patient came to the Emergency Ward, where physical examination showed that the temperature was 39.3°C. Crackles were heard at both lung bases, . . .