History of Present Illness

Patient X is a 60-year-old man presented to the emergency department with a chief complaint of
persistent right sided chest pain that is pleuritic in nature and had been present for the last month
and a cough that was productive of yellow sputum without hemoptysis. Patient X had
unintentionally lost approximately 30 pounds over the last 6 months and had nightly sweats. He
did not experience any fever, chills, myalgias or vomiting. He doesn’t have sick contacts or a
recent travel history but had exposures to persons afflicted with tuberculosis during his
childhood.

History of Past Illness

Patient X claims that he smoked cigarettes (1 pack daily) for the past 50 years but has no
recreational drug use. He drinks 12 beers daily and had experienced delirium tremens, remote
right-sided rib fracture and a wrist fracture as a result of alcohol consumption. He had worked in
the steel mills but he discontinued a few years previously. He used to collect coins and cleaned
them with mercury.

Patient X’s past medical history was remarkable for chronic “shakes” of the upper extremities for
which he had not sought medical attention. He took no regular medications other than daily
multivitamis.