Question

A 40-year-old man presents with a 5-day history of cough and purulent sputum. The patient has had recurrent attacks of cough with sputum production since his childhood. There are no other systemic complaints. The patient is febrile and has grade III finger clubbing. Rales are present all over the chest on auscultation. The chest X-ray shows a characteristic honeycomb appearance. What is the most likely diagnosis?

1. COPD
2. Tuberculosis
3. Bronchiectasis
4. Pneumonia
5. Cystic fibrosis

Answer 1

The patient's symptoms and chest X-ray findings suggest bronchiectasis as the most likely diagnosis.

Step-by-step explanation:

Given the patient’s history of recurrent cough with sputum production since childhood, the presence of fever, grade III finger clubbing, rales on auscultation, and a honeycomb appearance on chest X-ray, the most likely diagnosis is bronchiectasis. Bronchiectasis is characterized by permanent dilation of the bronchi and bronchioles, caused by chronic infection and inflammation. The symptoms of chronic cough and the production of purulent sputum, along with clubbing, are indicative of bronchiectasis rather than the other conditions listed such as COPD, tuberculosis, pneumonia, or cystic fibrosis, which tend to present differently.