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In this Journal feature, information about a real patient is presented in stages (boldface type) to an expert clinician, who responds to the information, sharing his or her reasoning with the reader (regular type). The authors' commentary follows.
A 26-year-old white man presented to our referral hospital with a 1-month history of persistent cough productive of white sputum, which was occasionally tinged with blood. He reported mild pleuritic chest pain but no dyspnea, fever, chills, night sweats, or weight loss. The patient had had no epistaxis or episodes of sinusitis. One week before presentation, his cough had been treated with
Commentary
Source Information
From the Department of Medicine, University of Pennsylvania, Philadelphia (A.E.S., D.S., R.E.P.); the Department of Medicine, National Jewish Medical and Research Center, Denver (W.J.J.); and the Ann Arbor Veterans Affairs Health Services Research and Development Center of Excellence and the Department of Internal Medicine, University of Michigan — both in Ann Arbor (S.S.).
Address reprint requests to Dr. Sareli at the Department of Medicine, Hospital of the University of Pennsylvania, 3400 Spruce St., Philadelphia, PA 19141, or at aharon.sareli@uphs.upenn.edu.
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