July 2015 critical care case of the month: an unusual presentation

• Main Authors: Kahn A, Wesselius LJ
• Format: Article
• Language: English
• Published: Arizona Thoracic Society 2015-07-01
• Series: Southwest Journal of Pulmonary and Critical Care
• Subjects: coccidioidomycosis; valley fever; mediastinal lymphadenopathy; brain abcess; MRI; CT scan; endobronchial lesion; bronchoscopy; endobronchial ultrasound; histology
• Online Access: http://www.swjpcc.com/critical-care/2015/7/2/july-2015-critical-care-case-of-the-month-an-unusual-present.html

No abstract available. Article truncated after 150 words. History of Present Illness: A 79 year old man was admitted because of a possible seizure. His wife found him unresponsive, displaying tonic-clonic motions with a right facial droop and right-sided weakness. He returned to consciousness, but was confused. A similar episode occurred 2 weeks prior to the present episode. He has additional symptoms of dysphagia with solid food for 6-8 months, a somewhat intentional 20 pound weight loss, night sweats for 4-5 months and fatigue for 1 year. Past Medical History: Coronary artery disease with a percutaneous transluminal coronary angioplasty in 1990, placement of 2 drug eluting stents in 2012; Idiopathic pulmonary fibrosis on 2-4 L/min home O2; Myelofibrosis on ruxolitinib, a monoclonal antibody against JAK receptors; Hypertension; A remote history of DVT/PE related to surgery with an IVC filter placed; Splenectomy due to trauma. Social and Family History: He has a 15 pack-year smoking history, quitting in 1985 ...