History A 27-year-old man presented to a pulmonologist to get a non-resolving lung cavity evaluated. Four months earlier, he was diagnosed with pulmonary tuberculosis and was put on four-drug antituberculous therapy. The patient mentioned that over the last year and a half, he had a cough occasionally productive of minimal blood-streaked sputum. He denied other symptoms, including nocturnal diaphoresis, anorexia, weight loss, or fever. Past medical history : It was remarkable; an abnormal chest X-ray was noted one and a half years ago, and one episode of malaria.
Social history: He smoked half a pack of cigarettes daily for the past 12 years. No history of alcoholism. Physical examination The patient appeared comfortable and was in no acute distress. Vital signs were unremarkable. Cardiac examination: Regular rate and rhythm, a normal S1 and S2, and no murmur, gallop, or rub.…
