Annals of Saudi Medicine
Publication of the King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
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Year : 2010  |  Volume : 30  |  Issue : 5  |  Page : 415

A middle-aged woman with cough, expectoration and fever

1 From the Department of Medicine, University College of Medical Sciences, Delhi, India
2 From the Department of Nephrology, Post Graduate Institute of Medical Education and Research, Chandigarh, India

Date of Web Publication 21-Aug-2010

Correspondence Address:
Vishal Sharma
19, Gobind Nagar, Subhash Road, Chheharta, Amritsar



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How to cite this article:
Sharma V, Sharma A, Kumar V. A middle-aged woman with cough, expectoration and fever. Ann Saudi Med 2010;30:415

How to cite this URL:
Sharma V, Sharma A, Kumar V. A middle-aged woman with cough, expectoration and fever. Ann Saudi Med [serial online] 2010 [cited 2010 Sep 11];30:415. Available from:

A 35-year-old woman presented with a history of productive cough and fever for a week. The fever was high grade and associated with chills. The sputum was yellowish and viscid. The patient had a history of recurrent episodes of cough and expectoration since childhood, which had needed frequent hospitalizations. Fifteen years after her marriage, she had no children. She was a nonsmoker. On examination her blood pressure was 126/80, pulse rate was 116/minute and respiratory rate was 36/minute. She had clubbing in all her digits. Her heart sounds were best heard on the right side of the chest, and the apex was best felt in right fifth intercostal space. The examination of the chest revealed bilateral crackles and rhonchi. Her chest roentgenogram revealed dextrocardia [Figure 1]. ECG showed a tall R wave in V1, an inverted P in lead I and aVL. A high-resolution CT of the chest confirmed the presence of dextrocardia and extensive bronchiectasis of the right lung and left lower lobe [Figure 2]. Ultrasound of the abdomen confirmed reversal of positions of abdominal viscera. The woman was managed with intravenous antibiotics, bronchodilalors and mucolytics. She improved with therapy, with remission of fever and reduction in sputum production. She was discharged 15 days later after improvement.
Figure 1: Chest roentgenogram showing dextrocardia.

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Figure 2: CT chest showing bronchiectasis.

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  [Figure 1], [Figure 2]


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