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Case Records of the Massachusetts General Hospital
Weekly Clinicopathological Exercises
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Volume 328:640-647 March 4, 1993 Number 9
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Case 9-1993— A 23-Year-Old Man with Fever, Dyspnea, Extensive Bilateral Pulmonary Infiltrates, and a Question of Heart Failure
John J. Reilly, and Eugene J. Mark

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Presentation of Case

A 23-year-old man was admitted to the hospital because of fever, bilateral pulmonary infiltrates, and worsening hypoxia.

The patient was apparently in excellent health until about one week earlier, when a dry cough developed, with a rise in the temperature to 38.9 °C and chilliness. A physician prescribed a cough preparation, without improvement. During the next few days diffuse arthralgias and myalgias appeared, with increasing fatigue. Two days before entry the patient became dyspneic, with pleuritic left-sided chest pain, and coughed up scanty amounts of blood.

On the same day the patient was admitted to another hospital, where physical examination . . . [Full Text of this Article]

Differential Diagnosis

Clinical Diagnosis

Dr. John J. Reilly, Jr.'s, Diagnosis

Pathological Discussion

Anatomical Diagnosis

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