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14yr old male who is a student resident of Nalgonda came with chief complaints of -
1)Fever since 8days
2)Cough since 8days
3)Shortness of breath since 8days
History of present illness :
Patient was apparently asymptomatic 8 days back then
- He developed fever,insidious in onset, continuous,low grade associated with chills and rigor and relieved on medication
- History of cough which was insidious in onset ,not associated with expectoration and no aggravated and relieving factors.
- History of shortness of breath,which is insidious in onset,progressed from grade1 to grade 2 (MMRC),aggravated on exertion and relieved on sitting position.
RESPIRATORY SYSTEM EXAMINATION :
Inspection :
-Trachea central
-Expansion of chest decreased on left side
Palpation:
-Trachea central in position
-Expansion of chest decreased on left side
-Vocal fremitus diminished in Interscapular , infrascapular ,infraaxillary on left side.
Percussion :
-Dull note on left Interscapular , infrascapular , infraaxillary area on left side.
Auscultation:
- diminished breath sounds on left side
- diminished vocal resonance in left infrascapular area, infraaxillary area and Interscapular area
Investigations :
Chest X ray
Provisional diagnosis:
Left sided pleural effusion
