A 67-year-old male with a history of advanced COPD and stage 4 non-small cell lung cancer which has progressed in spite of treatment with combination chemotherapy and radiation. The patient was admitted to the hospital with rapidly worsening dyspnea and cough. On initial examination, the patient had a respiratory rate of 33 breaths per minute, was using accessory muscles, could only speak short sentences, and appeared panicked. A chest X-ray revealed a right middle lobe infiltrate, compressive atelectasis, and a moderate-sized pleural effusion on the right side. The patient was initially started on Bi-level Positive Airway Pressure (Bi-PAP) to assist with his breathing and supplemental oxygen was also provided. The patient received intravenous antibiotics and was closely monitored for any signs of deterioration. Over the next few days, the patient's respiratory function slowly improved, and he no longer required Bi-PAP, though he continued to need oxygen support. Kindly suggest further management strategies that should be employed for his care.
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Dr. Rahul Gulati
General Practitioner
· Uttar Pradesh
Should be investigated for Aspergillosis