Age: 68.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19 pneumonia, Chest pain, Computerised tomogram thorax abnormal, Cough, Dyspnoea
Clinical narrative: Case completed primary Covid vaccine series in March 2021, then was  hospitalized in September and October 2021 for Covid.  Hospitalized at Hospital, discharging doctor: MD Hospitalist.    Discharge after hospitalization 9/23-9/27/21: Patient is a 69-year-old gentleman with remote history of colon cancer with remaining ostomy, former smoker, documented history of COPD though I do not see any PFTs on file who presented to the emergency department with 2 weeks of generalized weakness, weight loss, cough, night sweats, shortness of breath. He was positive for COVID-19 and met sepsis criteria. CT scan of his chest was notable for a consolidation throughout the right lower lobe with questionable 9.5 x 6.3 cm mass in the superior portion. Also a right hilar soft tissue attenuation likely causing narrowing of the right middle and lower lobe bronchus. He was initially requiring 3 to 4 L of oxygen. And was treated for postobstructive pneumonia with ceftriaxone, azithromycin, Flagyl. He was also started on on Decadron because of his positive Covid test. The patient is vaccinated however ID felt that there were also some imaging findings to suggest active Covid pneumonia here and perhaps that was playing a role in his hypoxemia. Case was discussed with on-call pulmonary medicine who recommended treatment of his acute infections and have the patient follow-up as an outpatient for further evaluation of his lung mass. ID was consulted and recommended a prolonged course of antibiotics given some concern for possible lung abscess formation. He was discharged on 3 weeks of Augmentin and with the plan that he will be seen in ID clinic before antibiotic stop date to determine whether he will need a longer course. He was discharged on 4 L of oxygen. . The patient's oxygenation remained stable and he felt significantly better at time of discharge and ready to go home. He also had 1 set of blood cultures that were growing 2 different organisms. This was thought to most likely be a contaminant however repeat blood cultures were drawn to ensure there is no persistent bacteremia. These will be monitored after discharge  DIscharge summary after hospitalized 10/4-10/7/2021: Briefly, this is a 69 y.o. male with PMH significant for recent COVID and Right lung mass with post-obstructive pneumonia on home o2 and augmentin who presented with worsening right lower anterior chest pain. Found to have completely collapsed RLL and enlarging mass on repeat imaging. Changed to unasyn while admitted and had CT-guided biopsy 10/4 that showed probable adeno of colonic origin with history of colon/rectal cancer in 2012. Pain was eventually controlled with every 6 hr oxycodone, and Dr did not feel benefit of XRT was worth risk as there was no specific culprit area obviously causing pain, therefore entire 11 x 7 cm mass would need irradiated. Plan to follow up with Doctor on Nov 1 to discuss palliation. Will stay on augmentin to prevent relapse as doubt RLL will ever be open again unless responds to palliation, and have follow-up with clinic.