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Clinical Problem-Solving
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Volume 345:756-759 September 6, 2001 Number 10
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The Effusion That Would Not Go Away
Petham Muthuswamy, M.D., Morufu Alausa, M.D., and Brendan Reilly, M.D.

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A 36-year-old man who was undergoing long-term hemodialysis was hospitalized with a two-day history of increasing dyspnea on exertion. He stated that he did not have cough, orthopnea, or night sweats.

On examination, he was found to be in mild respiratory distress, with a blood pressure of 156/68 mm Hg, a respiratory rate of 22, a pulse of 80 per minute, and a temperature of 38.3°C (100.9°F). The site of entry of a right subclavian dialysis catheter appeared unremarkable. There was edema of the left hand and an audible bruit over an arteriovenous shunt in the left forearm. The heart . . . [Full Text of this Article]

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From Cook County Hospital and Rush Medical College, Chicago.

Address reprint requests to Dr. Reilly at the Department of Medicine, Cook County Hospital, 1835 W. Harrison St., Chicago, IL 60612, or at breilly@cchil.org.

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