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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 promethazinecodeine preparation. An evaluation elsewhere showed that the hematocrit was 48.5 percent; the white-cell count was 7900 per cubic millimeter, with 68 percent
Differential Diagnosis
Clinical Diagnosis
Dr. Raymond L.H. Murphy's Diagnosis
Pathological Discussion
Anatomical Diagnosis
References
Related Letters:
Tuberculous Bronchiolitis
Couderc L.-J., Caubarrère I., Wiley E. L., Nightingale S. D., Mark E. J.
Extract |
Full Text
N Engl J Med 1996;
334:1748-1749, Jun 27, 1996.
Correspondence
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