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ClinicalA 64-year-old man presented with a low-grade fever (maximum temperature 37.5 degrees Celsius), malaise, nonproductive cough and dyspnoea for 1 week. Physically, fine crackles were heard at bilateral lung bases. Blood tests revealed a haemoglobin of 13.7 g/dl and a leukocyte count of 8,890/ 00b5l (neutrophil 65.8%, lymphocyte 28.9% and monocyte 3.5%). Smear of sputum specimens were negative for acid-fast bacilli and malignant cells.A chest radiograph (Figure 1) showed consolidations at bilateral lower lung fields. The patient was treated with oral amoxicillin/clavulanate plus clarithromycin for 14 days. However, pneumonia did not resolve in the follow-up chest radiograph. Computed tomography (CT) of his chest (Figure 2) revealed bilateral lung airspace consolidations with a predominantly peripheral distribution in the lower and middle zones. Figure 1 Figure 2 What is the diagnosis and how could it be confirmed? Answer
Summary
Abstract
Aim
Method
Results
Conclusion
Author Information
Acknowledgements
Correspondence
Correspondence Email
Competing Interests
- Alves dos Santos JW, Torres A, Michel GT, et al. Non-infectious and unusual infectious mimics of community-acquired pneumonia. Respir Med. 2004;98(6):488-94.-- Johkoh T, M 00fcller NL, Cartier Y, et al. Idiopathic interstitial pneumonias: diagnostic accuracy of thin-section CT in 129 patients. Radiology. 1999;211(2):555-60.-- Lynch DA, Travis WD, Muller NL, et al. Idiopathic interstitial pneumonias: CT features. Radiology. 2005;236(1):10-21.-
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ClinicalA 64-year-old man presented with a low-grade fever (maximum temperature 37.5 degrees Celsius), malaise, nonproductive cough and dyspnoea for 1 week. Physically, fine crackles were heard at bilateral lung bases. Blood tests revealed a haemoglobin of 13.7 g/dl and a leukocyte count of 8,890/ 00b5l (neutrophil 65.8%, lymphocyte 28.9% and monocyte 3.5%). Smear of sputum specimens were negative for acid-fast bacilli and malignant cells.A chest radiograph (Figure 1) showed consolidations at bilateral lower lung fields. The patient was treated with oral amoxicillin/clavulanate plus clarithromycin for 14 days. However, pneumonia did not resolve in the follow-up chest radiograph. Computed tomography (CT) of his chest (Figure 2) revealed bilateral lung airspace consolidations with a predominantly peripheral distribution in the lower and middle zones. Figure 1 Figure 2 What is the diagnosis and how could it be confirmed? Answer
Summary
Abstract
Aim
Method
Results
Conclusion
Author Information
Acknowledgements
Correspondence
Correspondence Email
Competing Interests
- Alves dos Santos JW, Torres A, Michel GT, et al. Non-infectious and unusual infectious mimics of community-acquired pneumonia. Respir Med. 2004;98(6):488-94.-- Johkoh T, M 00fcller NL, Cartier Y, et al. Idiopathic interstitial pneumonias: diagnostic accuracy of thin-section CT in 129 patients. Radiology. 1999;211(2):555-60.-- Lynch DA, Travis WD, Muller NL, et al. Idiopathic interstitial pneumonias: CT features. Radiology. 2005;236(1):10-21.-
For the PDF of this article,
contact nzmj@nzma.org.nz
View Article PDF
ClinicalA 64-year-old man presented with a low-grade fever (maximum temperature 37.5 degrees Celsius), malaise, nonproductive cough and dyspnoea for 1 week. Physically, fine crackles were heard at bilateral lung bases. Blood tests revealed a haemoglobin of 13.7 g/dl and a leukocyte count of 8,890/ 00b5l (neutrophil 65.8%, lymphocyte 28.9% and monocyte 3.5%). Smear of sputum specimens were negative for acid-fast bacilli and malignant cells.A chest radiograph (Figure 1) showed consolidations at bilateral lower lung fields. The patient was treated with oral amoxicillin/clavulanate plus clarithromycin for 14 days. However, pneumonia did not resolve in the follow-up chest radiograph. Computed tomography (CT) of his chest (Figure 2) revealed bilateral lung airspace consolidations with a predominantly peripheral distribution in the lower and middle zones. Figure 1 Figure 2 What is the diagnosis and how could it be confirmed? Answer
Summary
Abstract
Aim
Method
Results
Conclusion
Author Information
Acknowledgements
Correspondence
Correspondence Email
Competing Interests
- Alves dos Santos JW, Torres A, Michel GT, et al. Non-infectious and unusual infectious mimics of community-acquired pneumonia. Respir Med. 2004;98(6):488-94.-- Johkoh T, M 00fcller NL, Cartier Y, et al. Idiopathic interstitial pneumonias: diagnostic accuracy of thin-section CT in 129 patients. Radiology. 1999;211(2):555-60.-- Lynch DA, Travis WD, Muller NL, et al. Idiopathic interstitial pneumonias: CT features. Radiology. 2005;236(1):10-21.-
Contact diana@nzma.org.nz
for the PDF of this article
View Article PDF
ClinicalA 64-year-old man presented with a low-grade fever (maximum temperature 37.5 degrees Celsius), malaise, nonproductive cough and dyspnoea for 1 week. Physically, fine crackles were heard at bilateral lung bases. Blood tests revealed a haemoglobin of 13.7 g/dl and a leukocyte count of 8,890/ 00b5l (neutrophil 65.8%, lymphocyte 28.9% and monocyte 3.5%). Smear of sputum specimens were negative for acid-fast bacilli and malignant cells.A chest radiograph (Figure 1) showed consolidations at bilateral lower lung fields. The patient was treated with oral amoxicillin/clavulanate plus clarithromycin for 14 days. However, pneumonia did not resolve in the follow-up chest radiograph. Computed tomography (CT) of his chest (Figure 2) revealed bilateral lung airspace consolidations with a predominantly peripheral distribution in the lower and middle zones. Figure 1 Figure 2 What is the diagnosis and how could it be confirmed? Answer
Summary
Abstract
Aim
Method
Results
Conclusion
Author Information
Acknowledgements
Correspondence
Correspondence Email
Competing Interests
- Alves dos Santos JW, Torres A, Michel GT, et al. Non-infectious and unusual infectious mimics of community-acquired pneumonia. Respir Med. 2004;98(6):488-94.-- Johkoh T, M 00fcller NL, Cartier Y, et al. Idiopathic interstitial pneumonias: diagnostic accuracy of thin-section CT in 129 patients. Radiology. 1999;211(2):555-60.-- Lynch DA, Travis WD, Muller NL, et al. Idiopathic interstitial pneumonias: CT features. Radiology. 2005;236(1):10-21.-
Contact diana@nzma.org.nz
for the PDF of this article
Medical image. A case of nonresolving pneumonia
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