October 2013 pulmonary case of the month: a hidden connection

Abstract

No abstract available. Article truncated at 150 words. History of Present Illness A 58 year old woman, former smoker, presented to the pulmonary outpatient clinic at Mayo Clinic Rochester with dyspnea on exertion. In clinic, she was found to be tachycardic and febrile, and therefore, she was directly admitted to a medicine ward for possible sepsis. She had progressive dyspnea on exertion, accompanied by symptoms of dry cough, muscle weakness, dry mouth, easy bruising and constipation without weight loss for approximately 9 months. During this time, she was also diagnosed with an idiopathic pulmonary embolus with initiation of warfarin. PMH, SH, FH During an extensive work-up for these symptoms she was found to have a Ca2+ channel antibody, with concern raised for possible paraneoplastic etiology, as positron emission tomography (PET) imaging also revealed abnormal uptake in lungs along with multiple lymph nodes, pancreatic tail, decreased cerebral metabolism suggestive of a diffuse encephalopathy and bilateral pulmonary infiltrates with cavitation …

Keywords

• histoplasmosis
• mycology
• methods
• Pneumocystis jiroveci
• Legionella urinary antigen test
• urine histoplasma antigen
• serum histoplasma antigen
• Histoplasma capsulatum
• Cushing’s disease
• pituitary adenoma
• hyperadrenal
• hyperadrenalism
• immunocompromised host
• Cushing’s syndrome