ABSTRACT
You are reviewing patients in the medical outpatient clinic. Your next patient has been referred by his general practitioner with the following letter. Please read the letter and then review the patient.
Dear Doctor,
Re: Mr Rupert Wise
Age: 18 years
I would very grateful for your advice on this young lad who has been troubled with repeated chest infections over some time, which seem to be progressively worsening. He is producing copious amounts of purulent sputum and a recent culture has grown a strain of pseudomonas. Clinical examination shows a thin man with obvious finger clubbing. I have tried a number of antibiotics with no success and frankly am now at my wits’ end. Once again thank you for your help.
Yours sincerely
