17th February 2025

A 21-year-old man with significant mental health and self-care issues is brought in by ambulance to the emergency department.

A 21-year-old man with significant mental health and self-care issues is brought in by ambulance to the emergency department. On examination, he is very cachectic, has significant axillary lymphadenopathy and has stony dullness in the base of his left hemithorax. He has considerable flattening of his left chest wall with a left lateral purulent discharging ulcer on his thorax. 

Observations are as follows: respiratory rate 33, heart rate 105, temperature 38.3°C.

What is the likely diagnosis?

Select the SINGLE most appropriate option from the list below. Select ONE option only.