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A correction has been published: N Engl J Med 1995;333(9):607.

Case Records of the Massachusetts General Hospital
Weekly Clinicopathological Exercises
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Volume 333:241-248 July 27, 1995 Number 4
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Case 23-1995— A 44-year-old woman with pulmonary infiltrates, respiratory failure, and pancytopenia
S.R. Benatar, and E.J. Mark

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Presentation of Case

A 44-year-old woman was transferred to this hospital because of severe respiratory distress, bilateral pulmonary infiltrates, and increasing pancytopenia.

The patient had been well until 34 days earlier, when a cough productive of scanty whitish sputum developed. Treatment with erythromycin was unsuccessful. Progressive exertional dyspnea developed, and two weeks before entry she was admitted to another hospital. Examination showed that the temperature was 39.4°C; bilateral basal crackles were present. Radiographs of the chest revealed bilateral dense pulmonary infiltrates. Trimethoprim–sulfamethoxazole, doxycycline, and prednisone (40 mg twice daily) were administered.

On the fourth hospital day a bronchoscopic examination was complicated by hypoxemia . . . [Full Text of this Article]

Differential Diagnosis

Clinical Diagnosis

Dr. Solomon R. Benatar's Diagnosis

Pathological Discussion

Anatomical Diagnoses

References




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