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Case Records of the Massachusetts General Hospital
Weekly Clinicopathological Exercises
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Volume 347:517-524 August 15, 2002 Number 7
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Case 25-2002 — A 46-Year-Old Woman with Extensive Pulmonary Infiltrates
Katherine McGowan, and Eugene J. Mark

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Presentation of Case

A 46-year-old woman was admitted to the hospital because of extensive pulmonary infiltrates.

The patient had felt well until several weeks before admission, when she began to have abdominal swelling and increasingly severe jaundice. Twenty-six days before admission, she entered another hospital, where evidence of hepatic cirrhosis was detected, along with severe anemia and notable encephalopathy. Tests for occult blood in the stool were positive. The ammonia level was greater than 150 µmol per liter, the ceruloplasmin level was 19 mg per deciliter, and the urinary copper level was normal; serologic tests for hepatitis A, B, and C viruses, antinuclear . . . [Full Text of this Article]

Differential Diagnosis

Common Causes of Pneumonia

Causes of Progressive Pneumonia after Long Latency in Association with Immunodeficiency

            Mycobacterial Infection

            Parasitic Infection

            Fungal Infection

Clinical Diagnosis

Dr. Katherine McGowan's Diagnosis

Pathological Discussion

Anatomical Diagnosis


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