Elderly man with fever and cough: TB or not TB?

Abstract

An 81-year-old man with a history of hypertension, type 2 diabetes mellitus, hyperlipidemia, and psoriasis presented for admission to the hospital with productive cough, subjective fevers, chills, and malaise for 5 days. He had been treated for a similar episode approximately 10 months prior. At that time he was diagnosed with pneumonia, and he was prescribed azithromycin. While his symptoms subsequently improved, he was noted to have wheezing during the previous several months. The patient reported that he had been diagnosed with tuberculosis in his teens, treated only with home remedies. He denied weight loss, night sweats, sore throat, abdominal pain, nausea, vomiting, or diarrhea. He had chronic, mild, bilateral lower extremity edema.