Chest
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Case Reports
A 72-Year-Old Man With Innumerable Bilateral Pulmonary Nodules After Lung Transplantation.
A 72-year-old man who underwent bilateral orthotropic lung transplantation for interstitial lung disease 6 months ago presented to the clinic with a 2-week history of cough, shortness of breath, and mid-back pain. The donor was negative for cytomegalovirus (CMV) and positive for Epstein-Barr virus (EBV), and the recipient was positive for both CMV and EBV. He also reported headaches but denied any fever, chills, weight loss, night sweats, chest pain, orthopnea, paroxysmal nocturnal dyspnea, or leg swelling. ⋯ He never suffered from TB or had any exposure to patients with TB. His immunosuppressive regimen consisted of tacrolimus, mycophenolate mofetil, and prednisone. The targeted tacrolimus trough level was 10 to 12 ng/mL, and the patient was generally in the therapeutic range.
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A 53-year-old man was admitted with complaints of recurrent cough, mucopurulent phlegm, and fever for 10 days. These symptoms started in his youth, and he had experienced three or more acute attacks per year in the past 3 years. Persistent nasal obstruction was noticed. ⋯ The patient was married for 30 years and had a son. He had never used tobacco products or alcohol. A family history indicated that his parents were consanguineously married, and one of his sisters died of bronchiectasis coinfection.
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Case Reports
A 54-Year-Old Man With High-Grade Fever, Cough, Dyspnea, and Vesiculobullous Skin Eruptions.
A 54-year-old Egyptian man with a 5-day history of worsening cough, high-grade fever, and progressive dyspnea was referred to our hospital. A 3-day course of ceftriaxone provided in an outpatient setting showed no clinical improvement. Medical history was unremarkable, except for bilateral pulmonary embolism diagnosed 3 years earlier. ⋯ Five weeks before the actual presentation, he had traveled to Egypt. One of his children showed symptoms of a respiratory infection approximately 2 weeks before that. His only regular medication was rivaroxaban.
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A 52-year-old woman with a history of leiomyoma uteri and tobacco-use disorder in remission presented with 2 months of progressive back pain. Her pain was located between her shoulder blades and was described as constant with intermittent sharp, stabbing sensation. It was nonradiating and aggravated by inspiration. ⋯ She underwent a total hysterectomy 13 years ago for benign uterine fibroid tumors. She had a 15-pack-year history but quit smoking 3 years ago. Family history was notable for colon and pancreatic cancer in her father and breast cancer in her maternal aunt.