Preface

Most patients go to see their doctors because they have specific complaints. When people are suffering, whatever the cause, they want relief, either by treatment or by reassurance, and the sooner the better. The reasons why patients seek medical help have been catalogued, and complaints originating in the chest are always among the most common. Certain aches, pains, and functional upsets are often ignored for long periods, but the onset of cough, chest pain, or shortness of breath is frightening, signifying—as it may and as most people realize—grave internal mischief that warrants prompt attention. Equally worrying corollaries of this classic triad of chest-based symptoms are hemoptysis, wheezing, and stridor. The origin, differential diagnosis, and management of these six everyday symptoms, which impel patients to visit their frontline physicians, are described in this monograph.

In addition, this mongraph includes four other types of pulmonary presentations that frontline physicians are likely to have to cope with. The first is what to do about a positive tuberculin skin test reaction, which may have been detected as part of a routine office check up or in a survey carried out in school or the work place. Next, we discuss how to manage two common pulmonary disorders, pleural effusion and solitary pulmonary nodule, either of which may be an accidental chest x-ray finding or picked up in a film taken to evaluate a patient who presented with pulmonary symptoms. Finally, we review the perplexing problem of unresolved pneumonia, which nearly always turns up in someone initially thought to have ordinary community-acquired bacterial pneumonia, in whom a follow-up chest x-ray after antibiotic treatment reveals a persistent pulmonary infiltration.

As in our other monographs in this series, Frontline Treatment of Common Pulmonary Presentations aims to provide concise information of practical value that will assist frontline physicians in their daily struggles to deal with the multitude of patients who arrive in the office with many different kinds of problems. We do not intend this book as a compendium of “must-follow” guidelines. The contents can best be viewed as recommendations that were formulated by a group comprised of both academic and practicing specialists, all of whom have had considerable experience in the care of patients with pulmonary disease. We hope that readers will profit from the lessons that we have learned in our practices, and that, in turn, your patients will be the final beneficiaries. n

The Authors

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