History A 35-year-old man is sent to the accident and emergency department by his general practitioner (GP) after complaining of shortness of breath. The symptoms started 10 days ago with a chesty cough, which has become productive of yellow/brown sputum over the last week. He has also noticed increasing shortness of breath and reports a reducing exercise tolerance to less than two flights of stairs. He is a smoker of 10 cigarettes per week, with no relevant past medical or drug history.
On visiting the GP last week, some inspiratory crackles were heard on auscultation in the left mid zone, and a diagnosis of a respiratory tract infection was made. He was prescribed a course of amoxicillin but his symptoms have not resolved. He attended the GP today for follow-up and was referred to the accident and emergency department. Examination On examination he appears short of breath at rest with…
