A 32-year-old man with AIDS and a cavitary pulmonary lesion

Article Abstract:

A 32-year-old man with acquired immunodeficiency syndrome (AIDS) was admitted to the hospital because of difficulty in breathing, pain in the chest cavity, and an apparent abnormality in the right lung. His history indicated several prior incidents of Pneumocystis carinii pneumonia, a form of pneumonia that frequently affects AIDS patients, in the 15 months since his diagnosis with AIDS. He had been treated with pentamidine, an antiprotozoal agent, which improved his condition. Some weeks prior to his admission, the patient also suffered from fever, diarrhea, and breathing difficulty, following a vacation in the Dominican Republic. The diagnosis was a bacterial infection, campylobacter enteritis, for which he was treated with an antibacterial, erythromycin. At that point, he showed no evidence of the Pneumocystis pneumonia. The patient was both a musician and a practicing homosexual, and this lifestyle was considered partly responsible for his history of gonorrhea of the rectum, herpes, oral candidiasis (a fungal infection), and AIDS itself, for which he had been taking zidovudine (AZT), which he had discontinued. In addition, he had smoked a pack of cigarettes a day for 15 years. On the basis of various tests and examination of the symptoms, the clinical diagnosis reached was lung abscess of unknown cause. However, the pathological findings, on the basis of tissue samples, revealed evidence of Pneumocystis carinii and necrosis (tissue death) affecting the lung, as well as AIDS.

Complications and side effects, Lungs, Pneumocystis carinii pneumonia, AIDS (Disease), column, Lung abscess, Fanburg, Barry L.

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A 17-year-old boy with right-lower-lobe pneumonitis and asthma

Article Abstract:

A 17-year-old boy was admitted to the hospital complaining of a persistent cough with periods of flecks of blood in his sputum lasting for several days. He also complained of pain in his chest, apparently related to an inflammation of his pleura, the membranes which surround the lungs, as a result of his persistent cough. The patient had a 10-year history of insulin-dependent diabetes, and he also had mild asthma which was adequately controlled with common medications. During this illness his appetite disappeared and he lost approximately 10 pounds. Sputum specimens and blood samples were investigated for the presence of microorganisms, but nothing unusual was found. Ultimately he underwent bronchoscopy, a direct observation of the air passages of the lungs by the use of a nonflexible, periscope-like instrument inserted through the mouth. A small reddish tumor was obstructing one of the main branches of the bronchus and was accompanied by pus. The tumor was largely removed by suction for examination, and the fluids filling the lung were also removed. Microscopic analysis showed the tumor to be a carcinoid tumor, which often have a slow or indolent development. The patient was allowed to recover from his pneumonia and then underwent surgery to remove a segment of the affected lung. The patient remains free of disease with an excellent prognosis. During the diagnosis of this condition many different disease entities were considered before the final diagnosis could be made.

Case studies, Pneumonia, Lung tumors, Carcinoid, Carcinoid tumor, Bronchi, Zwerdling, Robert G.

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A 59-year-old woman with asthma and multiple pulmonary nodules

Article Abstract:

A 59 year old woman was admitted to the hospital with a history of childhood asthma, mild heart disease, blood clots in the leg complicated by an embolism, epilepsy, low thyroid function and chronic bronchitis. The patient's asthma had recurred two years before admission to the hospital and had been treated with medications that caused an allergic reaction. During the six months prior to the patient's admission she experienced increased difficulty breathing and a chronic productive cough. An abnormal lung x-ray showed opaque nodules. Sarcoidosis of the lung, a disease producing tubercle-like lesions on affected organs, was suspected and confirmed using a bronchoscope. The cause of the disease is unknown and there is no effective treatment.

Lung diseases, Sarcoidosis, Levine, Barry W.

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