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* resp 4
 #134182  
  dolly123 - 10/31/06 10:12
 
 
A 54-year-old black male from the southeast USA presents to you with complaints of generalized malaise, fever, and a cough. He claims that he has had intermittent hemoptysis for the past six months. He denies smoking and has never had tuberculosis. Examination is unremarkable and his chest x-ray is shown below. On changing position, you notice that the part of the lesion seen on x-ray also moves. The most likely diagnosis is?





A. Lung abscess
B. Pulmonary embolism
C. Aspergilloma
D. Histoplasmosis
E. Bronchiectasis

 
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* Re:resp 4
#537353
  malak - 10/31/06 10:14
 
  C. Aspergilloma  
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* Re:resp 4
#537357
  airmax - 10/31/06 10:15
 
  c  
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* Re:resp 4
#537509
  doc68 - 10/31/06 11:17
 
  E  
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* Re:resp 4
#537530
  mag - 10/31/06 11:29
 
  My answer is C.  
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* Re:resp 4
#537536
  dolly123 - 10/31/06 11:32
 
  c is right  
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* Re:resp 4
#537612
  doc68 - 10/31/06 11:59
 
  i was thinking brochiectasis , i dont know why?? i feel am good for nothing!!!  
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* Re:resp 4
#537620
  internalmed - 10/31/06 12:02
 
  ONLY THE BALL CAN MOVE IN THE LUNG,NEVER HEARD ANY MOVEMENT IN BRONCHIECTASIS  
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* Re:resp 4
#537621
  ben - 10/31/06 12:03
 
  So fungus ball, ok. How about Histoplasmosis do we see Pulm caviations as well??  
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* Re:resp 4
#537628
  malak - 10/31/06 12:08
 
  lesion seen on x-ray also moves--this is the clue  
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* Re:resp 4
#537761
  dolly123 - 10/31/06 13:46
 
  continuing with aspergillosis:

other clues in qs can be:
c/o white sputum with brown cords ( casts of bronchi)
seen in marijuana smokers
seen with high esionphil ..allergic bronchopulmonary aspergillosis
 
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