Thursday, February 23, 2006

What's the diagnosis

No history. 18 year old woman. What's your differential? How about some others leaving a comment (you can do so anonymously - you dont have to log in, just click comments below this post):

4 comments - CLICK HERE to read & add your own!:

Baleeiro said...

So, he has multiple non-calcified pulmonary nodules, many with cavitation. I don't see underlying parenchymal disease or large adenopathy.
He seems a bit young for malignancy but testicular cancer can present in this age group with multiple nodules. However, cavitation of metastatic lesions occurs in less than 5 percent of cases.
Wegener's can also present with multiple nodules and those are more likely to cavitate though he seems quite young.
I would favor an infectious etiology here. Septic emboli (perhaps IVDA) could look like these nodules, and so could histo. Cocci could also look like that but I think Jeff would have given us a little travel clue (same with Paragonimus...).

Anonymous said...

it's a WOman

Jennings said...

Good pick up. She is IVDA and has MRSA tricuspid endocarditis with septic emboli. She has a $200/day heroin habit and prostitutes for the cash. Surprisingly, she is HIV negative.

Mike L said...

Another thing that could do this is a peripharyngeal fascial 'space' infection.

If she was an "upstanding" member of the community, I would ask about upper resp symptoms (especially sore throat).

Cool CT