Chest
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A 21-year-old Hispanic woman with no significant medical history presented with complaints of progressive skin lesions for 3 months, associated with dyspnea and scant hemoptysis for 1 week. She initially developed painless subcutaneous nodules on her right forearm, which progressed to superficial ulcers and gradually spread to involve bilateral arms, thighs, chest, abdomen, and gluteal region. The lesions spared the head, neck, palms, and soles. ⋯ She was born in El Salvador but had spent most of her life in New York. She did not report any recent international travel or sick contacts. There was no personal or family history of immunodeficiency or malignancies.
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A 54-year-old Indian woman presented with low-grade fever and cough with expectoration for 1 month. Fever was not associated with any chills or night sweats. Expectoration was minimal in amount and mucoid in nature. ⋯ She neither traveled within or outside India in the past nor came in contact with patients with pulmonary TB. A chest radiograph was done because a prior workup showed an ill-defined solitary nodular lesion in the right lower zone. She took a course of amoxicillin-clavulanate, but that was of no benefit.
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A 60-year-old man was referred to a pulmonologist evaluation with persistent dyspnea and cough 1 month after discharge for an acute respiratory failure caused by Legionella pneumophila pneumonia, which required invasive mechanical ventilation. Chest CT scan performed during hospitalization showed lobar consolidation of upper left lobe (Fig 1A). ⋯ Chest radiograph after extubation showed almost complete resolution of infiltrates. After 1 month, the patient still complained of dyspnea and a new chest CT scan was performed: the consolidation migrated (Fig 1B; Video 1).