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Case Records of the Massachusetts General Hospital
Weekly Clinicopathological Exercises
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Volume 328:869-876 March 25, 1993 Number 12
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Case 12-1993— A 44-Year-Old Man with Pulmonary Disease and Proctitis
David S. Lazarus, and Eugene J. Mark

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Presentation of Case

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 . . . [Full Text of this Article]

Differential Diagnosis

Clinical Diagnosis

Dr. David S. Lazarus' Diagnosis

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