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Case Records of the Massachusetts General Hospital
Weekly Clinicopathological Exercises
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Volume 334:521-526 February 22, 1996 Number 8
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Case 6-1996— A 40-Year-Old Man with a Cough, Increasing Dyspnea, and Bilateral Nodular Lung Opacities
R.L.H. Murphy, and E.J. Merk

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Presentation of Case

A 40-year-old man was admitted to the hospital because of a persistent productive cough, dyspnea, and bilateral apical infiltrates.

The patient had been well until two months earlier, when "tightness" developed in the chest, followed several days later by a cough productive of yellowish-to-dark-brown sputum, with increasing dyspnea.

Thirty-four days before admission a small hemoptysis occurred. A beclomethasone inhaler, ofloxacin, lomefloxacin, and cefixime were prescribed in sequence, without benefit, although the cough was mildly improved with a promethazine–codeine preparation. An evaluation elsewhere showed that the hematocrit was 48.5 percent; the white-cell count was 7900 per cubic millimeter, with 68 percent . . . [Full Text of this Article]

Differential Diagnosis

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Dr. Raymond L.H. Murphy's Diagnosis

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References


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Extract | Full Text  
N Engl J Med 1996; 334:1748-1749, Jun 27, 1996. Correspondence

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