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A 48-year-old man was admitted to the hospital because of bilateral pulmonary infiltrates, bloody sputum, and microhematuria.
The patient was a physician who had been well until about eight years earlier, when paranasal sinusitis developed and became chronic. Seventeen months before admission, sinus surgery was performed at another hospital. Pathological examination of the excised material showed acute and chronic rhinosinusitis with stromal eosinophils.
Two months before admission, fever and epistaxis developed. The patient suspected that he had acute sinusitis and treated himself with azithromycin. Two days later, bilateral ear "pressure" developed, and exudates were observed over the tonsils, which were
Differential Diagnosis
Infection
Neoplasia
Vasculitis
Clinical Diagnoses
Dr. Richard L. Kradin's Diagnosis
Pathological Discussion
Anatomical Diagnosis
References
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