Pulmonary
The Southwest Journal of Pulmonary and Critical Care publishes articles broadly related to pulmonary medicine including thoracic surgery, transplantation, airways disease, pediatric pulmonology, anesthesiolgy, pharmacology, nursing and more. Manuscripts may be either basic or clinical original investigations or review articles. Potential authors of review articles are encouraged to contact the editors before submission, however, unsolicited review articles will be considered.
December 2017 Pulmonary Case of the Month
Lewis J. Wesselius, MD1
Michael B. Gotway, MD2
Departments of 1Pulmonary Medicine and 2Radiology
Mayo Clinic Arizona
Scottsdale, AZ USA
History of Present Illness
A 52-year-old woman from Iowa sought a second opinion for a left hilar mass. She travels to Phoenix regularly to visit family. She began feeling ill in late 2016 with cough and sputum production and was treated with multiple courses of antibiotics without improvement.
PMH, SH and FH
Past medical history is unremarkable. She is a nonsmoker. FH is noncontributory.
Physical Examination
Physical examination was normal.
Radiography
In March of this year she had chest radiograph in Phoenix which suggested left hilar adenopathy. A thoracic CT scan was performed (Figure 1).
Figure 1. Representative images from the thoracic CT scan in lung windows (A-E) and soft tissue windows (F).
Which of the following are diagnostic considerations? (Click on the correct answer to procced to the second of seven pages)
Cite as: Wesselius LJ, Gotway MB. December 2017 pulmonary case of the month. Southwest J Pulm Crit Care. 2017;15(6):232-40. doi: https://doi.org/10.13175/swjpcc144-17 PDF
July 2017 Pulmonary Case of the Month
Robert W. Viggiano, MD
Department of Pulmonary Medicine
Mayo Clinic Arizona
Scottsdale, AZ USA
History of Present Illness
The patient is a 19-year-old woman who went to a local Emergency Room 12/23/15 for chest pain she described as pleurisy. She was told she had pneumonia and a chest x-ray was reported to show a lingular infiltrate (Figure 1).
Figure 1. PA (A) and lateral (B) chest radiograph taken 12/23/15.
She was treated with antibiotics and improved. She was well until 9/2/16 when she again returned to the emergency room complaining of hemoptysis. A chest x-ray was reported as showing a lingular infiltrate (Figure 2).
Figure 2. PA (A) and lateral (B) chest radiograph taken 9/2/16.
She was treated with azithromycin but her cough persisted sometimes with a small amount of blood in her sputum. She was referred because of her persistent symptoms and her abnormal chest x-ray.
Past Medical History, Social History and Family History
- She is now taking fluoxetine daily.
- She has a history of pediatric autoimmune neuropsychiatric disorder associated with Group A Streptococcus and was treated with antibiotics for 4-5 years.
- Nonsmoker.
Physical Examination
Her physical examination was unremarkable.
Which of the following are true? (Click on the correct answer to proceed to the second of five pages)
- Her chest radiographs are consistent with pneumonia
- Lung cancer is an unlikely consideration in a 19-year-old
- The chest x-ray findings represent a well-known complication of pediatric autoimmune neuropsychiatric disorder
- 1 and 3
- All of the above
Cite as: Viggiano RW. July 2017 pulmonary case of the month. Southwest J Pulm Crit Care. 2017;15(1):1-6. doi: https://doi.org/10.13175/swjpcc082-17 PDF