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A 44-year-old man was admitted to the hospital because of a nonproductive cough and dyspnea.
The patient had been well until 25 months earlier, when hematochezia, diarrhea, and urgency of stool passage developed. Sigmoidoscopic examination showed erythema, edema, and friability of the rectum, and microscopical examination of a biopsy specimen revealed active chronic proctitis, with ulceration, cryptitis, and crypt-abscess formation; examination of specimens stained for fungi, amebae, and acid-fast bacilli was negative. The patient disliked topical therapy, and prednisone (30 mg daily) was begun four months before admission. His symptoms resolved, and prednisone was tapered and discontinued seven weeks before
Differential Diagnosis
Clinical Diagnosis
Dr. David S. Lazarus' Diagnosis
Pathological Discussion
Anatomical Diagnosis
References
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