19 / 21
Page 43
Notes:
Volume 2
Journal of Molecular Cancer
Cancer & Primary Healthcare 2019
May 20-21, 2019
Cancer Research & Oncology
Primary Healthcare and Medicare Summit
May 20-21, 2019 | Rome, Italy
25
th
Global Meet on
World Congress on
&
Lung cancer mimicking community acquired pneumonia
Muhammad Idrees
USA
Introduction:
Lungcancersometimescanmimicorpresentasnon-resolvingpneumonia.Patientsusuallypresent
with pneumonia like symptoms not resolving over course of 1-2 weeks despite being treated with antibiotics.
Case:
43-year-old female with an active smoking history of 20 years presented to us with complaints of fever,
cough, fatigue, headache, and shortness of breath. One month prior to presentation, he traveled by car for 2
days after spending 2 months in Louisiana. She was recently seen at an outside hospital with similar complaints,
where she was treated with a 10-day course of amoxicillin-clavulanate for presumed community acquired
pneumonia. On presentation, patient's vitals were BP 127/87, Pulse 117, Temp 38C, and Oxygen saturation
88%. On examination, she was noted to have decreased breath sounds on the right lower lung and swelling of
the left leg. Pertinent labs included an elevated white blood cell count (13.4), eosinophils (790), and D-dimer
(27,529). Due to concerns for PE, CT thorax was done, which showed extensive multifocal consolidation of the
right and left lungs, mediastinal lymphadenopathy, bilateral pleural effusions more pronounced on the right
side, and pericardial effusion. A small PE was also noted on left side. Leg Duplex showed an acute DVT of the
left leg. The patient was started on IV Heparin for the acute DVT and PE. Per pulmonology recommendation,
she was started on antibiotics for suspected severe multi-focal community- acquired pneumonia. She proved
refractory to antibiotic treatment. Subsequent work-up for atypical pneumonia included cold agglutinin titer/
Mycoplasma titers, Q fever, Chlamydia titers 1:64, Strongyloides, Histoplasma, Fungitell, Cryptococcus, and
HIV. All were negative. Cardiac surgery and pulmonary team were consulted. Patient had pericardial window
drainedandpleuralpig-tailplaced.Bronchoscopywasalsodone.Fluidcytologywaspositiveforadenocarcinoma
of lung. Further imaging studies revealed metastases to the brain , left adrenal gland and sacral spine.
Discussion:
Patients presenting with pneumonia like symptoms and not improving despite treatment
with antibiotics should undergo further work up to rule out other causes including lung cancer. High
clinical suspicion is required for the early diagnosis as delayed diagnosis can lead to poor prognosis.
idreessoomro@gmail.comJ Mol Cancer, Volume 2