April 2018 pulmonary case of the month

Abstract

No abstract available. Article truncated after 150 words. History of Present Illness A 74-year-old woman with known chronic obstructive pulmonary disease (COPD) presented to emergency department on 2/4/18 with dyspnea. She had been hospitalized at another hospital from 12/29/17 - 1/30/18 for a COPD exacerbation and health care associated pneumonia described as a cavitary pneumonia. She was treated with various doses of systemic steroids and antibiotics. Her course was complicated by atrial fibrillation with a rapid ventricular response. She eventually was discharged to a skilled nursing facility. Past Medical History, Social History and Family History She has a known history of COPD with an FEV1 of 22% of predicted and is on 2L/min of O2 by nasal cannula. There is also a history of: • Hypertension. • Hypercholesterolemia. • Paroxysmal atrial fibrillation, not on anticoagulation. • Right 4 mm PICA aneurysm. She lives in rural Kingman, AZ with some dust and outdoor bird exposure. Family history is noncontributory. Medications • Alprazolam 0.25 mg …

Keywords

• cytomegalovirus
• CMV
• COPD
• corticosteroid
• immunocompromised
• cystic lung disease
• CT scan
• chest x-ray
• viral inclusion
• diagnosis