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M. O. M., a white woman aged 31, was admitted to St. Lukes Hospital on April 5, 1944 with a story of fever, cough, dyspnea, chest pain, palpitation and slight hemoptysis of about four days' duration. The patient had been treated at home during this time, with a diagnosis of lobar pneumonia. She was acutely ill and apparently getting progressively worse.
The physical examination revealed that the breath sounds in the left lower chest were high pitched and tubular in character. Whispered voice and spoken voice were both greatly increased over the same area. The percussion note was dull over the entire left lower lung field. The heart tones were very faint in character and were scarcely audible even though the patient was very thin. Tension was 108/70. The heart was enlarged to the midaxillary line on the left and 3 cm. beyond the sternum on the right.
Wise AW, Shafer LE. PURULENT PERICARDIAL EFFUSION TREATED WITH PENICILLIN GIVEN INTRAPERICARDIALLY. JAMA. 1945;127(10):583. doi:10.1001/jama.1945.92860100002007a