Correct!
5. All of the above
The patient is young and previously healthy and so an infectious etiology is likely. A CBC is indicated to look for a high white blood cell count with a left shift possibly indicative of an infection. His hemoglobin was lower than expected for a healthy, young man at 12.3 g/dL. The white blood cell count was not elevated and there was no left shift or eosinophilia. Liver function testing would be indicated since co-existing liver disease is possible but were only mildly elevated. Coccidioidomycosis or Valley Fever is very common in Arizona and a coccidioidomycosis serology is indicated but our patient's was negative. A thoracic CT would help to better define the effusion and examine the mediastinum and is shown in Figure 3.
Figure 3. Representative images from thoracic CT scan in lung windows (A-C) and soft tissue windows (D-F).
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