Dyspnea and Night Sweats in a 46-Year-Old Man

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Dyspnea and Night Sweats in a 46-Year-Old Man

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Roza Chaireti, MD; Mats Pettersson, MD

January 15, 2020

Editor’s Note:
The Case Challenge series includes difficult-to-diagnose conditions, some of which are not frequently encountered by most clinicians but are nonetheless important to accurately recognize. Test your diagnostic and treatment skills using the following patient scenario and corresponding questions. If you have a case that you would like to suggest for a future Case Challenge, please contact us.

A 46-year-old man presents to the emergency department with a 5-day history of progressively worsening breathlessness on exertion and mild, general flulike symptoms. He also complains about night sweats and an intermittent low-grade fever, both of which started about 2 weeks ago.

Upon physical examination, the patient does not appear to be in any acute distress. His vital signs are measured as a pulse of 89 beats/min, blood pressure of 140/85 mm Hg, and a respiratory rate of 19 breaths/min. He is afebrile, with a temperature of 99.8°F (37.7°C).

The chest examination reveals nothing out of the ordinary, and his cardiovascular and respiratory examinations, including auscultation, are unremarkable. The abdominal examination reveals no fluid thrill, shifting dullness, or bruit. The liver and the spleen are not enlarged. No lymph nodes are palpable.

Multiple areas of hyperpigmentation are noted; otherwise, the skin inspection is unremarkable, with no hematomas, bruises, wounds, or scars noted. Electrocardiography (ECG) reveals a sinus rhythm with a heart rate of 84 beats/min, and the T waves are somewhat flattened in leads V1, aVL, and III, but they are otherwise unremarkable.

Medscape © 2020 
WebMD, LLC

Cite this: Dyspnea and Night Sweats in a 46-Year-Old Man – Medscape – Jan 15, 2020.

Staff Physician, Department of Emergency Medicine, Linköping University Hospital, Linköping, Sweden

Disclosure: Roza Chaireti, MD, has disclosed no relevant financial relationships.

Staff Physician, Department of Cardiology, Linköping University Hospital, Linköping, Sweden

Disclosure: Mats Pettersson, MD, has disclosed no relevant financial relationships.

Craig A. Goolsby, MD, Director, eMedicine Case of the Week; Staff Physician, Department of Emergency Medicine, Wilford Hall Medical Center, Lackland Air Force Base, San Antonio, TX

Disclosure: Craig A. Goolsby, MD, has disclosed no relevant financial relationships.

Usama Basit, MD, MBBS, Reviewer, eMedicine Interactive Case Studies (CME Case of the Week), Rawalpindi, Pakistan

Disclosure: Usama Basit, MD, MBBS, has disclosed no relevant financial relationships.

S.A. Jamal Bokhari, MD, Associate Professor of Radiology – Yale University School Of Medicine. Section Chief Emergency Radiology, Assistant Program Director Radiology Residency – Yale New Haven Hospital, New Haven, CT

Disclosure: S.A. Jamal Bokhari, MD, has disclosed no relevant financial relationships.

Winston Tan, MD, Assistant Professor and Consultant, Department of Hematology/Oncology, Mayo Clinic, Jacksonville, FL

Disclosure: Winston Tan, MD, has disclosed the following relevant financial relationships:
Received grants for clinical research from Genentech, Bristol-Myers Squibb, OncoGeneX, and Sanofi-Aventis.

Luis M. Soler, BA, Associate Editor, eMedicine/Medscape, New York, NY

Disclosure: Luis M. Soler, BA, has disclosed no relevant financial relationships.

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Dyspnea and Night Sweats in a 46-Year-Old Man

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Dyspnea and Night Sweats in a 46-Year-Old Man

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