A 28-Year-Old Man Develops Headache, Nausea, Cough, Shortness of Breath

A 28-year-old man develops headache, nausea, cough, shortness of breath, and fatigue while hiking the Mount Whitney Summit Trail in California.  The patient arrived 3 days ago from Los Angeles.  He is also accompanied by his friend who came from New Jersey, but his friend does not have any symptoms.  The patient has no medical conditions and takes no medications.  He drinks 3 or 4 beers every day.  Temperature is 38.3 C (101 F) , blood pressure is 130/90 mm Hg, pulse is 120/min, and oxygen saturation is 85% on ambient air.  Examination shows cyanosis, dry mucous membranes, and bilateral crackles.  Chest x-ray reveals diffuse, patchy infiltrates and normal heart size.  Laboratory studies reveal leukocytes of 14,000/mm³ with 74% neutrophils.  Serum procalcitonin level is 0.10 mcg/L (normal: <0.25) .  What is the most likely diagnosis in this patient?

A) Acute Chagas disease
B) Aspiration pneumonia
C) Heart failure with preserved systolic function
D) Noncardiogenic pulmonary edema
E) Streptococcal pneumonia

Correct Answer:

Verified

Unlock this answer now
Get Access to more Verified Answers free of charge

Access For Free