[18F] Experiencing severe night sweats, coughing up blood, and chest pain

Patient Description

An 18-year-old female has been experiencing severe night sweats for approximately 2 months, which are intense enough to require opening a window and removing clothing. The patient also reports a dry cough, chest pain, and coughing up blood-stained mucus. There has been a noticeable loss of appetite and a 7-pound weight loss over the same period. The patient has a history of bulimia, for which she went into recovery 2 years ago. Current medications include Methylphenidate, Limotrogine, Guanficine, Sertraline, and Hydroxizine as needed. The patient also reports frequent vaping, which she believes may be exacerbating her cough.

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Arora's Assessment

What might be happening

Based on the information you've provided, the following conditions could be causing your symptoms:

  • Tuberculosis: This is a serious bacterial infection that mainly affects the lungs. The bacteria that cause tuberculosis are spread from person to person through tiny droplets released into the air via coughs and sneezes. Symptoms can include a cough that lasts more than three weeks, chest pain, and coughing up blood or sputum (phlegm from deep inside the lungs). Night sweats, weight loss, and loss of appetite are also common symptoms.

    • Treatment typically involves a course of several antibiotics for 6 to 9 months.
  • Lung Cancer: This is a type of cancer that begins in the lungs. People who smoke have the greatest risk of lung cancer, though lung cancer can also occur in people who have never smoked. Symptoms can include a new cough that doesn't go away, coughing up blood, shortness of breath, chest pain, hoarseness, losing weight without trying, and bone pain.

    • Treatment options include surgery, radiation therapy, chemotherapy, targeted therapy drugs, and immunotherapy.
  • Pneumonia: This is an infection that inflames the air sacs in one or both lungs. The air sacs may fill with fluid or pus (purulent material), causing cough with phlegm or pus, fever, chills, and difficulty breathing. Night sweats can also be a symptom.

    • Treatment is usually with antibiotics, rest, fluids, and medication to relieve symptoms.
  • Chronic Obstructive Pulmonary Disease (COPD): This is a chronic inflammatory lung disease that causes obstructed airflow from the lungs. It's caused by long-term exposure to irritating gases or particulate matter, most often from cigarette smoke. Symptoms include breathing difficulty, cough, mucus (sputum) production and wheezing.

    • Treatment includes medications, pulmonary rehabilitation, oxygen therapy, and sometimes surgery.

Please note that these are potential conditions that could explain your symptoms based on the information you've provided. It's important to consult with a healthcare provider for an accurate diagnosis.

What you can do

  1. Make an appointment with your healthcare provider as soon as possible to discuss your symptoms. They may refer you to a specialist or order tests to help determine the cause of your symptoms.
  2. If you smoke or vape, consider quitting. Both can contribute to lung disease and other health problems.
  3. Keep a symptom diary. Note when your symptoms occur, their severity, and any potential triggers. This information can help your healthcare provider make a diagnosis.

What you should look out for

Seek immediate medical attention if:

  • Your cough or chest pain worsens.
  • You cough up more blood.
  • You have difficulty breathing.
  • You experience severe weakness or fatigue.
  • You have a high fever.

Remember, I'm an AI and this advice is based on the information you've provided. It's always important to consult with a healthcare provider for an accurate diagnosis and treatment.

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11 mo ago

People Also Ask


What are the common symptoms of tuberculosis?

Common symptoms of tuberculosis include a persistent cough lasting more than three weeks, chest pain, coughing up blood or sputum, night sweats, weight loss, and loss of appetite.


Can vaping contribute to lung problems?

Yes, vaping can contribute to lung problems. It can irritate the lungs and exacerbate symptoms like coughing and shortness of breath, and may increase the risk of developing chronic lung conditions.


What are the potential side effects of the medications the patient is taking?

The medications listed can have various side effects. Methylphenidate may cause insomnia or increased heart rate, Lamotrigine can cause skin rashes, Guanfacine may lead to drowsiness or dizziness, Sertraline can cause nausea or sexual dysfunction, and Hydroxyzine may result in drowsiness or dry mouth.


How can one differentiate between symptoms of pneumonia and lung cancer?

Pneumonia often presents with symptoms like fever, chills, and a productive cough with phlegm, while lung cancer may present with a persistent cough, coughing up blood, unexplained weight loss, and chest pain. However, both conditions can have overlapping symptoms, so medical evaluation is necessary for an accurate diagnosis.


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