BOF 74

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BOF: 74

A 28 year old paddy farmer in Thailand presents with a history of right sided chest pain aggravated by breathing of a week’s duration.

On examination he was febrile , the pulse rate was 110 beats per minute, heart sounds were normal , the trachea was in the midline but respiratory movements were decreased at the right base , percussion note was decreased at the right base and there were diminished breath sounds at the right base.

He had marked intercostal tenderness on the right side 9^th intercostal space mid axillary line.

Hb 14 g/dl

WBC 21 x10⁹/L

Platelets 570 x10⁹/L

ESR 80 mm in 1^st hour

In this patient which of the following tests is most likely to enable you to reach a preliminary diagnosis and facilitate initial treatment?

a)      Chest X-ray

b)      Bronchoscopy

c)      Pleural aspiration

d)     Sputum culture

e)      Abdominal ultrasound scan

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