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Case Records of the Massachusetts General Hospital
Weekly Clinicopathological Exercises
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Volume 347:1009-1017 September 26, 2002 Number 13
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Case 30-2002 — An Eight-Year-Old Girl with Fever, Hemoptysis, and Pulmonary Consolidations
Brian P. O'Sullivan, Lori A. Erickson, and John L. Niles

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Presentation of Case

An eight-year-old girl was admitted to the hospital because of fever, cough, hemoptysis, and pulmonary consolidations.

She had been well until six days before admission, when she was visiting El Salvador. A sore throat developed, with mild fever, a dry cough, and anorexia, and she began to vomit once daily. Three days before admission, she traveled by air to Boston, where she lived, and dyspnea developed. The next day, she began to cough up bright red blood and had right-sided otalgia and a sore throat; the low-grade fever persisted. The hemoptysis and dyspnea worsened, and she was taken to another . . . [Full Text of this Article]

Differential Diagnosis

Goodpasture's Syndrome

Systemic Lupus Erythematosus

Small-Vessel Vasculitides

Wegener's Granulomatosis

Microscopic Polyangiitis

Diagnostic Tests for Small-Vessel Vasculitides

            Tissue Biopsy

            Antinuclear Cytoplasmic Antibodies

Summary

Clinical Diagnoses

Dr. Brian P. O'Sullivan's Diagnosis

Pathological Discussion

Anatomical Diagnosis




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