| Symptoms
& History
Physical
Findings
Stop
& Think
Lab
and X-Ray
Differential
Diagnosis
The
Disease
Treatment
Conclusions
Quiz
& Evaluation
|
|
The possibilities now:
-
Alveolar proteinosis.
-
Toxic pulmonary injury, such
as smoking injury combined with industrial or agricultural chemical (Paraquat?)
-
Diffuse pulmonary lymphatic
involvement with metastatic carcinoma.
-
Pulmonary infection acquired
in his travels (coccidiomycosis?)
-
AIDS with secondary pulmonary
infection (pneumocystis?)
-
Leaving anything out?
|
|
Where next?
In order to proceed, we need
to know the nature of the pulmonary infiltrate.
The gram stain on his sputum
didn't give us much and waiting for the culture results may be a mistake.
Bronchoscopy
seems the next course of action. |