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Case Records of the Massachusetts General Hospital
Weekly Clinicopathological Exercises
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Volume 328:1696-1703 June 10, 1993 Number 23
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Case 23-1993— A 30-Year-Old Man with a Dry Cough, Dyspnea, and Nodular Pulmonary Lesions
Joel B. Karlinsky, and Eugene J. Mark

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Presentation of Case

A 30-year-old man was admitted to a hospital because of a chronic cough and increasing exertional dyspnea.

The patient had been well until 18 months earlier, when a monarticular arthritis developed in the right second finger after he had camped in the woods in southeastern Massachusetts. Antibiotic treatment for Lyme disease was administered empirically, with symptomatic improvement. Fourteen months before admission the patient's reserve unit was activated for service in Operation Desert Shield. Seventeen days later he arrived at Fort Devens, Massachusetts, and five days after his arrival he experienced nausea, vomiting, sweats, and fever, without respiratory tract symptoms. Two . . . [Full Text of this Article]

Differential Diagnosis

Clinical Diagnosis

Dr. Joel B. Karlinsky's Diagnosis

Pathological Discussion

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References



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