An 80-Year-Old Man With Dyspnea and Bilateral Pleural Effusions After Partial Nephrectomy for Renal Cell Carcinoma

摘要: An 80-year-old man presented because of superficial head trauma sustained after falling from bed. On review of systems, he reported worsening dyspnea on exertion, nonproductive cough, and weight loss over the preceding 2 to 3 months. There was no report of chest pain or leg swelling. He had a past medical history hypertension, coronary artery disease, subclinical hypothyroidism, renal cell carcinoma treated with partial right nephrectomy approximately 1 year before this presentation. Two months earlier he had been evaluated in the dermatology clinic for painful, dystrophic fingernails. At that time diagnosed acropachy onycholysis suspected superinfection, failing improve vinegar soaks topical antimicrobials, underwent surgical nail removal on second fourth digits hand. Histological examination operative specimens revealed nails negative fungal stains. His medications included levothyroxine, hydrochlorothiazide, clopidogrel. He had never smoked done clerical work until retirement. originally Colombia.