A 32-year-old man complains of pain in the chest on the left, dyspnea, temperature rise up to 38,0°C, slight cough. The disease onset was 2 weeks ago after overexposure to cold. He had suffered from bronchoadenitis in his childhood. The affected side lags during breating; percussion reveals dull sound with oblique margin in the lower left lung, where breathing is absent. The right heart border is displaced outwards. Mantoux test with 2 TU resulted in a papule 16 mm in size. What diagnosis is most likely?

Answer options

1. Community-acquired pneumonia
2. Congestion pneumonia
3. Tuberculous pleurisy
4. Central carcinoma of the left lung
5. Thromboembolism of the pulmonary artery branches

Explanation

A 32-year-old man complains of pain in the chest on the left, dyspnea, temperature rise up to 38,0oC, slight cough. The disease onset was 2 weeks ago after overexposure to cold. He had suffered from bronchoadenitis in his childhood. The affected side lags during breathing; percussion reveals dull sound with oblique margin in the lower left lung, where breathing is absent. The right heart border is displaced outwards. Mantoux test with 2 TU resulted in a papule 16 mm in size. What diagnosis is most likely?A. Tuberculous pleurisy results from inflammation of the membrane that covers the lungs (the pleura) caused by exposure to Mycobacterium tuberculosis bacteria infecting the lungs. B. Central carcinoma is one of the non-small cell carcinomas of the lung, overtaken by adenocarcinoma of the lung as the most encountered lung cancer. C. Congestion pneumonia is a form of pneumonia that affects a large and continuous area of the lobe of a lung. It is one of the two anatomic classifications of pneumonia. D. Thromboembolism of the pulmonary artery branches usually arise from thrombi that originate in the deep venous system of the lower extremities; however, they rarely also originate in the pelvic, renal, upper extremity veins, or the right heart chambers. E. Community-acquired pneumonia refers to pneumonia (any of several lung diseases) contracted by a person with little contact with the healthcare system. The main difference between hospital-acquired pneumonia (HAP) and CAP is that patients with HAP live in long-term care facilities or have recently visited a hospital. It’s tuberculosis pleurisy because tuberculosis of intrathoracic lymphatic nodes (“broncho adenitis” was present in the patient’s childhood, strongly positive Mantoux test result).