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IMMUNOLOGY
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Productive cough A 68-year-old man
attending a meeting in Philadelphia presented with dyspnea, fever of
40.4, chills, productive cough, pleuritic chest pain, headache,
lethargy, watery diarrhea, and myalgias 3 days after his arrival. He had
a history of 75 pack years of smoking and emphysema. X-rays on the day
he presented showed asymmetrical infiltrates of the lungs which had
progressed significantly 36 hours later. Physical examination showed
localized rales, hypotension, and tachypnea. Lab studies showed a slight
increase SGOT and SGPT. LDH was 495 U/L and microscopic hematuria was
present. Within 24 hours of hospitalization, oliguria developed. Blood
cultures were negative. Empiric antibiotic therapy was begun. He
continued to decline and died. The image below was taken of his lungs at
autopsy. |
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