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A 54-year-old woman was admitted to the hospital because of respiratory failure, hypotension, and a cavitary lesion in the lung.
She had rheumatoid arthritis but had otherwise been well until approximately 1 week before admission, when upper respiratory symptoms, cough, and shortness of breath developed. On the day of admission, shortness of breath worsened. She called her physician, who advised her to go to a hospital for evaluation. While she was preparing to leave her home, her symptoms increased in severity; she collapsed, and emergency medical services (EMS) were called.
When they arrived, the patient was unconscious and showing minimal
Differential Diagnosis
Pulmonary Manifestations of Rheumatoid Arthritis
Malignant Tumors
Infections
Treatment of Rheumatoid Arthritis
Bacterial Infections
Mycobacterial Infection
Fungal Infection
Summary
Clinical Diagnosis
Dr. Michael E. Weinblatt's Diagnosis
Pathological Discussion
Anatomical Diagnosis
Source Information
From the Division of Rheumatology, Immunology, and Allergy, Brigham and Women's Hospital (M.E.W.); the Departments of Radiology (G.F.A.) and Pathology (A.F.K.), Massachusetts General Hospital; and the Departments of Medicine (M.E.W.), Radiology (G.F.A.), and Pathology (A.F.K.), Harvard Medical School — all in Boston.
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