Thursday, October 13, 2005
Followup on lung lesion
Remember this case of the Jehova's witness with the growing lesion in the RLL? A bronch showed some greenish secretions. The BAL was cloudy but colorless. It was negative for actinomycetes and nocardia (no growth x 6 days so far). There were 4000 cfu/mL of alpha hemolytic strep with > 1 PMN per oil immersion field. The cytology was read as "acute inflammation". Do you all think this whole thing is due to a chronic a-hemolytic strep infection?
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I don't know, Jeff... Strep is not a typical "chronic" bug forming "streptococcomas". It might have been a superinfection on the abnormal tissue. I agree that it is worth treating it but i would be surprised if that's a "Strep ball"...
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