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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

Brian Kennedy, Respiratory House Officer; Lutz Beckert, Respiratory Physician; Respiratory Medicine, Christchurch Hospital, Christchurch

Acknowledgements

Correspondence

Dr Lutz Beckert, Respiratory Medicine, PO Box 4345, Christchurch Hospital, Christchurch, New Zealand. Fax: +64 (0)3 3640914

Correspondence Email

Lutz.Beckert@cdhb.govt.nz

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

Brian Kennedy, Respiratory House Officer; Lutz Beckert, Respiratory Physician; Respiratory Medicine, Christchurch Hospital, Christchurch

Acknowledgements

Correspondence

Dr Lutz Beckert, Respiratory Medicine, PO Box 4345, Christchurch Hospital, Christchurch, New Zealand. Fax: +64 (0)3 3640914

Correspondence Email

Lutz.Beckert@cdhb.govt.nz

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

Brian Kennedy, Respiratory House Officer; Lutz Beckert, Respiratory Physician; Respiratory Medicine, Christchurch Hospital, Christchurch

Acknowledgements

Correspondence

Dr Lutz Beckert, Respiratory Medicine, PO Box 4345, Christchurch Hospital, Christchurch, New Zealand. Fax: +64 (0)3 3640914

Correspondence Email

Lutz.Beckert@cdhb.govt.nz

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

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