Clinical Pathological Conference Ⅲ
Abstract of clinical history (A78015)
A 47 years old male patient was admitted to the hospital on 19 th Aug. 1978 with chief complaint of moderate fever, cough and dyspnea for 1/2 month, loss consciousness for 4 days. Three months before hospitalization, the patient had a history of dry cough and 2 months later the cough was accompanied with dilute white sputum. Half month ago there were fever, yellowish-white sputum associated with dyspnea and then followed by loss of consciousness. He was treated by the use of tetracyclomycin, bipenicillin without any good result. Later on, using kanamycin, it was in fail also. The past history and family history was nothing particularly, except a large skin scar acompanied by recurrent ulcer and purulent exudation on the surface of it for 20 years. P. E. Temp. 37.5o C pulse 100, Resp. 36,  B.P. 100/80 mm Hg. Cachexia, loss consciousness, superficial respiration, moist rales difussed through out the whole lungs covering up the heart murmurs. The abdomen was soft and nonpalpable of liver and spleen. Edema in the ankle regions of lower extremities, mutiple dermatoerythematous scarring lesions in the skin with ulceration and purulent secretions over it, foul in odor.

  Lab exam revealed Hgb 9.6, W.B.C. 2 400 with PMN 90%. Lymphocytes 10%, Plat. 86 000.

  After hospitalization, oxygen inhalation, parenteral injection of fluid, antibiotic treatment but not improved at all and the patient died 14 hours later with sudden stopped of respiration and followed by ceasing of heart beat.