Case 4-2003 - A 42-Year-Old Woman with Cough, Fever, and Abnormalities on Thoracoabdominal Computed Tomography

doi:10.1056/NEJMcpc020027

Volume 348:447-455		January 30, 2003		Number 5

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 ofa productive cough, chills, and fever.

The patient had been well until seven months earlier, when anintermittent, generally nonproductive cough developed and didnot resolve, despite courses of several antibiotics. A chestradiograph was said to be unremarkable. A few months beforeadmission, another chest radiograph was believed to show a hiatalhernia, but a barium-swallow examination failed to reveal thehernia. Several days before admission, the patient began tocough up green, foul-smelling sputum and had a temperature ashigh 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.