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Computed tomography of the chest. (A) Before treatment, with right pulmonary infiltrates. (B) After 1 year of itraconazole, with marked improvement.

Sickle Cough: A Case of Nonresolving Pneumonia

A 26-year-old female graduate student with sickle-cell disease presented with fever, dyspnea, and right shoulder pain. Computed tomography of the chest demonstrated right middle and lower lobe infiltrates (Figure, A). She was diagnosed with pneumonia, acute chest syndrome, and vaso-occlusive crisis and prescribed 5 days of amoxicillin-clavulanic acid.   She was readmitted 1 month later […]

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Bronchoscopy showing pill fragments (arrow) with intense inflammatory granulation response with bronchial stenosis.

Unusual Cause of Persistent Cough: ‘Pill Aspiration’

A 57-year-old woman with carcinoid syndrome was referred to the pulmonary clinic by her primary care physician (PCP) for persistent cough for the past 6 weeks. She was evaluated by her PCP approximately 6 weeks earlier for cough, which the patient thought started after she had aspirated one of her medications. Results from initial clinical […]

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(A) Skin impairment. Papulonodular skin lesions on the tip of the nose, from 3 to 10 mm, characteristic of sarcoidosis: firm, nonedematous, noninflammatory, nonpainful, nonpruriginous, with predominant facial involvement. (B) Endoscopic view (right nasal fossa) showing a major mucosae thickening. (C) Numerous uniform circumscribed nests of non-caseating granulomata which are characterized by the paucicity of lymphocytes and absence of necrosis.

Skin and Nasal Involvement: Look for Sarcoidosis!

  Sarcoidosis is a systemic, noncaseating, granulomatous disease affecting young adults between the ages of 25 and 40 years, most often of Black origin (35.5/100,000 vs 10.9 in the White population). Although the lower respiratory tract is affected in 90% of cases, ear, nose, and throat locations are very uncommon, with a prevalence varying between […]

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(A) Coronal computed tomography demonstrating extensive bilateral ground-glass opacification, most pronounced at the periphery, and anterior lobular septal thickening. (B) Effluent, initially noted to be milky, cleared with progressive saline infusions during lung lavage.

Severe Pulmonary Alveolar Proteinosis in a Young Adult

  Pulmonary alveolar proteinosis is a rare lung disorder characterized by abnormal accumulation of surfactant within alveoli. Clinical presentation is nonspecific, but associated with characteristic radiologic findings and unique management options. We highlight a case of severe pulmonary alveolar proteinosis requiring total lung lavage in a young healthy man. Case Report A 37-year-old man with […]

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Spider graph to depict the effect size values on changes in health-related quality of life and its subscales and dyspnea scores from baseline to 1 year, according to percent-predicted VO2 peak <80% and >80% at 1 year. Concentric circles around the central target represent effect size in mean changes in scores from baseline to 1 year.4 Health-related quality of life and dyspnea scores improved more in patients with percent-predicted VO2 peak >80% at 1 year (distance between central point [0.0] and blue line) compared with patients with percent-predicted VO2 peak <80% at 1 year (distance between central point [0.0] and red line). PEmb-QoL = pulmonary embolism quality of life questionnaire; SF-36 = Short-Form Health Survey-36; SOBQ = University of California at San Diego Shortness of Breath Questionnaire.

Quality of Life, Dyspnea, and Functional Exercise Capacity Following a First Episode of Pulmonary Embolism

We aimed to evaluate health-related quality of life (QOL), dyspnea, and functional exercise capacity during the year following the diagnosis of a first episode of pulmonary embolism. Methods This was a prospective multicenter cohort study of 100 patients with acute pulmonary embolism recruited at 5 Canadian hospitals from 2010-2013. We measured the outcomes QOL (by […]

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A, Single variably hypopigmented papule over the left upper eye. B, Multiple hyperpigmented maculopapular rash over the neck. C, Magnetic resonance imaging of the lumbosacral spine reveals a mottled appearance of the bone marrow on the T1-weighted images. D, CT scan of the chest reveals multiple scattered nodules over both lung fields uniformly distributed without any zonal preference. E, Multiple similar-appearing noncaseating epithelioid granulomas were observed on bone marrow biopsy.

The Great Masquerader Strikes Again!

To the Editor: A 42-year-old man presented with symptoms of severe low-back pain that was aggravated by activity and bending. He also reported sharp pains radiating down the back of the right thigh. In addition, he had an occasional mild cough with yellowish-gray sputum production. He denied any weight loss, night sweats, fevers, or chills. […]

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