Le Prof. Dominique Savary ( CHU d’Angers ), presents a clinical case in emergency medicine.
Presentation
This is an 82-year-old patient admitted to the emergency room for respiratory discomfort increasing for 1 to 2 weeks with the notion of fever and asthenia for 1 week. At the onset of symptoms, he presented with a pustular rash on the hands and around the fingernails which regressed.
The nurse organizing the reception notes in his report:
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Blood pressure: 132/76 mm Hg
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Heart rate: 112/min
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Score the Glasgow : 15
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Respiratory rate: 30/min
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SaO2: 90% in ambient air
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Temperature: 38.9°C
The patient is put on oxygen, installed in a vital emergency reception room.
Among the patient’s history, you note:
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Arterial hypertension (HTA)
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Dyslipidemia
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Suspicion of rheumatoid arthritis for 6 months (but not confirmed, no exploration initiated, put on trial treatment)
Its treatment combines:
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Anti-HTA
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IPP
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Statins
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Corticosteroid therapy
Regarding the way of life, the patient is autonomous, he lives alone with his cat, does his shopping and his garden. He is up to date with the anti-COVID vaccination, with a last reminder 15 days ago. He never smoked.
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Cite this article: Clinical case: difficulty breathing, fever and asthenia in an elderly patient – Medscape – June 6, 2022.