What's your diagnosis? – Case 5: mysterious lungs

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Miss B is a 25 year old administrative clerk who, over the last six months, noticed that she was becoming increasingly short of breath. Initially she thought it might be due to the fact that she gave up her gym routine, but over the past two months she noticed that she gets short of breath even while she’s watching TV.

A month ago she went to her GP with persistent coughing. He decided to treat her for asthma when he heard wheezing while listening to her lungs. His diagnosis concerned Miss B as she had no family history of asthma.  She also has no smoking history. She did not lose weight and does not sweat at night. She had no recent Tuberculosis contact.

A month ago, when Miss B noticed bloody phlegm when coughing and blood her urine, she decided to seek a second opinion. She is now so short of breath that she can hardly do any work.  While waiting in the doctor’s surgery she suddenly collapsed. 

When the doctor listened to her chest he could hear no breathing sounds on the left side of her chest.  He diagnosed a pneumothorax on clinical grounds and placed a chest drain. When he placed the chest drain, a milky substance drained from the chest cavity.

Miss B’s doctor admitted her to hospital and ordered a special investigation.

What’s your diagnosis?

What’s your diagnosisJoin the guesswork on our Facebook page, or comment below. 

NOTE: Health24's on-site GP Dr Owen Wiese will reveal new cases on Thursdays and we'll post the answer with the story on Mondays, or you can find out via the Daily Tip – sign up here.

Previously on What's Your Diagnosis

What's your diagnosis? -  Case 1: vomiting and weight loss
What's your diagnosis? -  Case 2: eye pain
What's your diagnosis? -  Case 3: strange behaviour and a bullet in the back?
What's your diagnosis? -  Case 4: seeing odd things

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