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Case 23 

Case 23
Chapter:
Case 23
Author(s):

John Stradling

, Andrew Stanton

, Najib Rahman

, Annabel Nickol

, and Helen Davies

DOI:
10.1093/med/9780199556373.003.023
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date: 14 December 2017

An 88-year-old woman was admitted with a 6-month history of progressive shortness of breath, a cough productive of small volumes of clear sputum and lethargy. In the preceding 3 weeks her symptoms had worsened, also with episodes of feeling hot and shivery. Three courses of antibiotics from her GP had not improved symptoms. She had previously been given a diagnosis of late onset asthma, on the basis of several year’s history of shortness of breath and wheezing at night, worse in the springtime and with exposure to oil seed rape. She had no other atopic history. Symptoms had improved a little with inhaled beclomethasone 200µg, two puffs twice daily and salbutamol, as required. She was an ex-smoker with a 10-pack year history.

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