A Young Adult with Worsening Cough: Using Lung POCUS to Diagnose Early Pneumonia
Case Presentation
A 24-year-old man presents to a primary care clinic with seven days of respiratory symptoms. He initially developed cough, fever, sore throat, and fatigue. His symptoms improved on days 4 and 5, but then worsened in the past 48 hours with recurrent fever and productive green sputum.
Patient’s past medical history is notable for asthma, well-controlled with an as-needed inhaler. COVID-19 and influenza testing are negative. On exam, he is febrile but otherwise well appearing, with normal oxygen saturation. Lung auscultation reveals faint crackles at the right lower lung base without wheezing. Given concern for a post-viral bacterial pneumonia, the clinician performs a point-of-care ultrasound (POCUS) of the lungs. Representative clips of the right and left lungs are shown below.
What do you see, and what’s the diagnosis?
