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Case Records of the Massachusetts General Hospital
Weekly Clinicopathological Exercises
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Volume 348:447-455 January 30, 2003 Number 5
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Case 4-2003 — A 42-Year-Old Woman with Cough, Fever, and Abnormalities on Thoracoabdominal Computed Tomography
Lindsey R. Baden, M.D., and Danielle D. Elliott, M.D.

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Presentation of Case

A 42-year-old woman was admitted to the hospital because of a productive cough, chills, and fever.

The patient had been well until seven months earlier, when an intermittent, generally nonproductive cough developed and did not resolve, despite courses of several antibiotics. A chest radiograph was said to be unremarkable. A few months before admission, another chest radiograph was believed to show a hiatal hernia, but a barium-swallow examination failed to reveal the hernia. Several days before admission, the patient began to cough up green, foul-smelling sputum and had a temperature as high as 38.5°C, without chills or sweats. A chest . . . [Full Text of this Article]

Differential Diagnosis

Cavitary Pulmonary Lesions

            Pulmonary Abscess

            Mycobacterial or Fungal Infection

Hepatic Cysts

Unifying Processes

            Echinococcus granulosus

            Treatment of Echinococcal Infection

Clinical Diagnosis

Dr. Lindsey R. Baden's Diagnosis

Pathological Discussion

Anatomical Diagnosis


Source Information

From the Division of Infectious Disease, Brigham and Women's Hospital (L.R.B.); the Department of Pathology, Massachusetts General Hospital (D.D.E.); and Harvard Medical School (L.R.B., D.D.E.) — all in Boston.



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