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Case Records of the Massachusetts General Hospital
Weekly Clinicopathological Exercises
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Volume 339:1457-1465 November 12, 1998 Number 20
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Case 34-1998— A 71-Year-Old Woman with Fever, Hypotension, and Changing Cardiac Findings
David E. Gossman, Noah Liel-Cohen, and Edi Brogi

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Presentation of Case

A 71-year-old woman was admitted to the hospital because of fever, dyspnea, and hypotension.

Her history included an inferior myocardial infarction 19 years earlier; hypertension; renal insufficiency ascribed to chronic pyelonephritis, with a creatinine level ranging from 1.8 to 2.2 mg per deciliter (159.1 to 194.5 µmol per liter); a left nephrectomy; and chronic paranoid schizophrenia. There was a mass in the right middle lobe and a calcified right hilar lymph node, both of which had remained unchanged on periodic radiographic assessment for seven years.

Twelve weeks before the current admission, the patient was admitted to the hospital because of . . . [Full Text of this Article]

Differential Diagnosis

Clinical Diagnosis

Dr. David E. Gossman's Diagnoses

Pathological Discussion

Anatomical Diagnoses

References



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