43 yr old male with cough and right lower limb weakness

February 21, 2021

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Here is a case i have seen

A 43 old male patient came with the

C/o neck pain , c/o weakness of rt lower limb since 6 months,

c/o cough with sputum since 6 months ,

c/o fever since 6 months

Patient was apparently asymptomatic 6 months back then he developed neck pain which was sudden in onset gradually progressive and taken to yashoda hospital and pain relieved on medication

C/o weakness of rt lower limb which was gradual in onset ,progressive in nature associated with tingling sensation & numbness

History of fever ( on and off) since 6 months which was low grade not associated with chills and rigors, associated with diurnal variation , night sweats. Patient observed wt loss since 1 month , complains of cough with sputum ( 6 months),non foul smelling.

c/o hemoptysis since 10 days ( 2- 3 ml) with clots

C/o loss of appetite

K/C/O alcoholic and smoker since 20 yrs , beedi - 1 pack per day and stopped 1 yr back

Respiratory system examination

Inspection

Rt supraclavicular hollowness

Movements of chest appears to be reduced on right side in supraclavicular region

Palpation vocal fremitus decreased in rt supraclavicular area

Percussion

dull note in rt supraclavicular and suprascapular region

Auscultation

Wheeze in bilateral lung fields on presentation