Case 1-2006 -- A 64-Year-Old Male Lung-Transplant Recipient with Fever, Cough, Hemoptysis, and Abdominal Pain

doi:10.1056/NEJMcpc059039

Volume 354:180-187		January 12, 2006		Number 2

Case 1-2006 — A 64-Year-Old Male Lung-Transplant Recipient with Fever, Cough, Hemoptysis, and Abdominal Pain

Robert H. Rubin, M.D., Matthew D. Gilman, M.D., and Richard L. Kradin, M.D.

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Presentation of Case

A 64-year-old man with emphysema who had received a double-lungallograft six months previously was admitted to the hospitalbecause of cough, hemoptysis, and abdominal pain.

Three days before admission, abdominal pain that was localizedto the left lower quadrant developed. Two days before admission,the patient began to have small-volume hemoptysis (approximatelyone teaspoon) on awakening. His appetite was poor, but he wasable to drink liquids. He did not have diarrhea, melena, hematochezia,shortness of breath, or chest pain. On the evening before admission,fever to 38.3°C developed, associated with shaking chills.The patient vomited once the next . . . [Full Text of this Article]

Differential Diagnosis

Clinical Diagnosis

Dr. Robert H. Rubin's Diagnosis

Pathological Discussion

Anatomical Diagnosis

Source Information

From the Division of Infectious Disease, Brigham and Women's Hospital (R.H.R.); the Departments of Radiology (M.D.G.) and Pathology (R.L.K.), Massachusetts General Hospital; and the Harvard/Massachusetts Institute of Technology Division of Health Science and Technology (R.H.R), Medicine (R.H.R.), Radiology (M.D.G.), and Pathology (R.L.K.), Harvard Medical School — all in Boston.