Case Study #3
A 31-year-old male injection drug user presents to the emergency d

Case Study #3
A 31-year-old male injection drug user presents to the emergency department with a chief complaint of shortness of breath. He is unemployed and lives with his father, who is at his bedside. He describes a 1-month history of intermittent fevers and night sweats associated with a nonproductive cough. He has become progressively more short of breath, initially dyspneic only with exertion but now dyspneic at rest. He appears to be in moderate respiratory distress. His vital signs are abnormal, with a temperature of 39°C, heart rate of 112 bpm, respiratory rate of 20/min, and oxygen saturation of 88% on room air. Physical examination is otherwise unremarkable but notable for the absence of abnormal lung sounds. Chest x-ray film reveals a diffuse interstitial infiltrate characteristic of pneumocystis pneumonia, an opportunistic infection.