Tuesday, November 21, 2006

Dyspnea


I have just seen this 47 y/o woman for new onset dyspnea. She has had malaise, non-productive cough and DOE for the past 6 weeks. Occasional "low-grade" temps but no fevers.
No TOB Hx. She works at a auto air-bag manufacturer and part-time at a Wal-Mart. No other exposures. Exam is pretty unremarkable. PFTs revealed a mild restrictive deffect with low DLCo.
Any suggestions? (BTW, ignore the small apical PTx, that was from vigorous bronching). Posted by Picasa

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

Jennings said...

Couldn't zoom in but it looks like diffuse tiny nodules. Doesn't look like any ground glass but can't tell from film (and if it's high res or not).
Although there is a low grade temp, I would think she would be more symptomatic if this was, say, disseminated histo - but she is around that area geographically.
Malignancy is a possibility. Does she have adenopathy? What types of exposures are at work (the airbag place of work)? The radiograph does not seem consistent with a diagnosis of HP but this could be a consideration.
I assuem you bronched with BAL for micro, cell count cytology and TBBX?

krayem said...

looks like HP to me..........