What is your DDx and what would you do next?
Tuesday, December 20, 2005
Pulmonary infiltrates
This is a 68 y/o man with a very remote TOB Hx (quit >20 years ago) who had an interesting initial presentation of persistent neck adenopathy since 1995. He had had many non-diagnostic biopsies over the years and was treated for toxo. He finally had an excisional Bx of an 8x6 cm neck node and was found to have Hodgkin's. He had mediastinal adenopathy at the time (7/05) and has received 3 cycles of ABVD. He was set up for another cycle in early December but presented to the hospital with worsening dyspnea, cough (non-productive) and fatigue and was found to be hypoxemic. He is not neutropenic but is quite hypoxic and I have posted his CxR and CT chest below.
What is your DDx and what would you do next?
What is your DDx and what would you do next?
Subscribe to:
Post Comments (Atom)
1 comments - CLICK HERE to read & add your own!:
This is an ongoing case so I will give you a little update. We had the same concerns described by Doug: we titrated his O2 to keep his Sats 88-90% trying to avoid further oxidative toxicity with the Bleo. He was started on broad-spectrum ABTx including Bactrim and steroids and just had a bronch.
I will post result as they become available.
Post a Commenttest post a comment