Cough with persistent production of clear sputum
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A 90 year old ex-smoker and retired builder was admitted to a surgical ward after developing an uncomplicated right sided inguinal hernia. On admission he gave a history of a cough with persistent production of clear sputum. He was otherwise asymptomatic, with no recent weight loss. Examination was unremarkable but chest radiography (fig 1) was undertaken.
(2) Patients may present with pleuritic chest pain (sharp pain when breathing), dyspnoea (shortness of breath), and cough. Some symptoms are the result of the cause itself—for example, malignancy might cause weight loss. Signs of a pleural effusion include: mediastinum shifted away from side of effusion; decreased tactile vocal fremitus; decreased vocal resonance; pleural rub (sounds like walking in snow; usually seen in the early stages); bronchial breathing above the level of the effusion; no breath sounds over the pleural effusion, where it will also be stony dull to percussion. In some cases chest