Monday, October 30, 2006

Follow up to the 66 year old with tree in bud

This woman had presented with hemoptysis once and a CT scan showed tree in bud pattern and some nodularity. She presented a year later with cough and sputum. A culture had previously shown 1/3 AFB + but non-TB and non-avium. Her symptoms are the daily cough without constitutional symptoms and no shortness of breath.
I sent off a sputum and it showed Many PMNs, few Epithelial cells, many Gram positive cocci in pairs, chains and clusters and rare Gram negative bacilli.

What would you do now?

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