Chest
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An 86-year-old Singaporean Malay woman with no known respiratory condition presented with 2 weeks of progressively worsening dyspnea, cough, and pleuritic chest pain. There was a positive sick contact and recent long-distance travel to Norway. However, further history revealed her symptoms presented even prior to her overseas trip. Red flag symptoms of hemoptysis, loss of appetite/weight, and risk factors such as smoking/occupational exposure, and personal and familial history of cancer were absent.
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A 47-year-old Hispanic woman presented to a pulmonology clinic with 2 weeks of cough productive of white sputum and worsening dyspnea on exertion, requiring increasing supplemental oxygen. In addition, she reported fatigue, night sweats, diffuse myalgias, and extremity weakness. She denied hemoptysis, fevers, chills, weight loss, or rash. ⋯ Elevated CK at that time was attributed to compartment syndrome before amputation. The patient recovered clinically with supportive care and was ultimately discharged on 2 L supplemental oxygen, with a diagnosis of acute respiratory failure of unclear origin. The patient had stability in her clinical symptoms until this current presentation.
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A 53-year-old man presented to the ED at a time of low severe acute respiratory syndrome coronavirus 2, also known as coronavirus disease 2019 (COVID-19), prevalence and reported 2 weeks of progressive shortness of breath, dry cough, headache, myalgias, diarrhea, and recurrent low-grade fevers to 39°C for 1 week with several days of recorded peripheral capillary oxygen saturation of 80% to 90% (room air) on home pulse oximeter. Five days earlier, he had visited an urgent care center where a routine respiratory viral panel was reportedly negative. ⋯ He reported a past medical history of gastroesophageal reflux disease that was treated with famotidine. Travel history included an out-of-state trip 3 weeks earlier, but no recent international travel.
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Editorial Comment
Antacid Therapy in Idiopathic Pulmonary Fibrosis: A Swinging Pendulum.