TB vs pneumo

[BombayBombshell]

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hmmm ok feel dumb even asking this q...but oh well....

came across this q in q-bank: 57 yo man presents w/ an episode of shaking chills the previous night. He has now developed R-sided pleurtic chest pain, fever, sweats, malaise, purulent sputum and mild hemoptysis. PE: R basilar rales. CXR: R-lower lobe infiltrate

so, ok my first thought was oh TB b/c of the hemoptysis, sweats, shaking chills...but i guess the lobar consolidation and purulent sputum makes it pneumo? the acute presentation?

i think i'm having a brain freeze...how is it possible to get something as basic as TB and pneumo confused?!... 😳 Please help!

brinda

 

[FoxyDoc]

This seems like more of an acute presentation than that of TB. You're right about the sweating and chills being associated with TB, but you would probably also have some weight loss and be experiencing the symptoms for longer than just a day or so.
Sometimes the reasoning that they use on QBank about why an answer is correct has led me to believe that some of the question writers may indeed be smokin' the crack pipe! Don't feel stupid about not understanding their reasoning because it usually doesn't make any sense.

 

[BombayBombshell]

thanks foxy!

according to the "explanations" the presentation is a "typical" pneumonia. It makes sense that a TB patient would have WL etc and not have an acute presentation a la strep pneumo...

feeling just a little less dumb,

~brin 🙂

 

[imtiaz]

when you think TB, think chronic. history of months.
(histo, blasto, coccido, paracoccido also go here, then they'll tell you where the patient has traveled)

when you think pneumo (caused by strep pneumo, etc) think a history of a week max.
(for causative organism, they'll tell you that the patient is alcoholic, nursing home, hospitalized, etc. age is also important here ex: newborns and group B strep)

the symptoms are similar, the timeframe/age is the biggest difference.

 

[BombayBombshell]

Thanks!!!