August 2014 pulmonary case of the month: a physician's job is never done

Abstract

No abstract available. Article truncated at 150 words. History of Present Illness: A 75-year-old man presented with recurrent minimally productive cough, dyspnea, fatigue, low-grade fevers, and weight loss in November 2013. The patient had been treated twice as an outpatient with antibiotics in the previous 6 weeks for pneumonia. PMH, FH, SH: The patient has a history of obstructive sleep apnea but is not compliant with his prescribed continuous positive airway pressure. He also as a history of obesity, dyslipidemia, and peripheral vascular disease. There is no significant family history. He is a retired brick layer with a 50 pack-year smoking history but quit a few weeks prior to admission. He drinks a case of beer/week. Physical Examination: VS stable. There were no significant findings on physical examination. Radiography: A chest radiograph (Figure 1) was performed. What should be done next? 1. Bronchoscopy with bronchoalveolar lavage; 2. Bronchoscopy with transbronchial biopsy; 3. Needle biopsy; 4. Thoracentesis; 5. Video-assisted ...

Keywords

• cryptogenic organizing pneumonia
• COP
• broncholitis obliterans organizing pneumonia
• BOOP
• leukemia
• histology
• CT scan
• thoracic CT scan
• corticosteroids
• secondary cause