A fifty year old diabetic hypetensive male,presented with mild fever since one day,chest discomfort and restlessness since last 1 hour.His BP was 140/80,pulse100/min,respiratory rate was 28/min,afebrile at the time of examination.His spo2 was66%.his resting ecg was normal and chest xray showed a dense right upper lobe consolidation.TLC was 24400,90% were neutrophils and random blood sugar was 251.his sputum for AFB was negative and gram stain revealed gram positive cocci in chains.CLINICAL PEARLS:This is acase of lobar pneumonia with atypical presentation.Diabetes is responsible for such altered appearance of the disease.The patient deteriorated rapidly without any prior warning signs or symptoms.So one has to be very careful while dealing with a diabetic pneumonia.
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