I am consulting some of my professors at VUSM about this case, who knows, they might be able to help him. Diagnosis for the first part was pretty common, and I am sure that the Dr.'s caught on immediately. He spoke of a fever, cold chills, and shoulder pain. Fever is the body's way of fighting off infection, the fact that he spoke of cold chills says that he was running a temp above 102.1. His body was pretty much going into shock. Temperatures 104.1 can cause severe brain damage, and even death. The plaque that he spoke of sounds common of "Pulmonary Edema" which is fluid building up in the lungs. He mentioned something about asbestos, but if it were this agent, he would have noticed blood in the sputum, as asbestos cuts up lung tissue. As far as his shoulder pain, most heart problems are characterized by the numbness of extremeties and/or hemispheres. It sounds more like a growth of some kind. This is just my guestimations though, keep in mind that I am still a student and that ANY of the above information should be taken as an opinion and not considered a medical fact. As far as Actinomycosis goes, I have included a link from the U.S. National Library of Medicine and the National Institutes of health on the subject.
http://www.nlm.nih.g...icle/000599.htm
Message to Pat if you are reading: I hope you get better real soon buddy. :)