During a recent VGH CTU Lunch Rounds, Dr. Michael Heer (our very own IM R3 and soon to be UBC GIM fellow) presented a fascinating case of a 75-year-old man with HFpEF, atrial fibrillation, and type 2 diabetes. The patient presented with worsening shortness of breath and bilateral pedal edema, prompting a diagnostic journey through potential causes, including heart failure and parapneumonic effusion.
The case evolved into a complex diagnosis of fungal empyema due to coccidioidomycosis, an unexpected twist linked to the patient’s potential exposure to an endemic area. Management involved antifungal therapy and surgical intervention with thoracic decortication.
Dr. Heer’s discussion highlighted the importance of considering uncommon diagnoses in complex clinical scenarios and provided valuable insights into the diagnosis and management of challenging pleural infections.
Check out this link for his slide deck!
Vancouver IM LMR 
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