11-29-2006, 09:29 PM
74 year old male with progressive cellulitis after getting bruised when gardening with shrubs. History of fever of 102. Treated unsuccessfully with Augmentin. Traveled to mexico 6-weeks ago. Married, no drug, alcohol hx.
Physical Exam: No cervical lymphadenopathy, with erythema extending to left chest
LABS: WBC 6000, Hct 36, ESR 92, AST 183, LDH 283, ALT 173, Alk phos 7, GGT normal
CXR: mediastinal and rt. hilar lymphadenopathy. Rt and left lobe masses.
MRI: no clavicular osteomyelitis
AFB and fungal stains Negative
Bx of lung mass: granulomatous inflammation, possibily vasculitic
Physical Exam: No cervical lymphadenopathy, with erythema extending to left chest
LABS: WBC 6000, Hct 36, ESR 92, AST 183, LDH 283, ALT 173, Alk phos 7, GGT normal
CXR: mediastinal and rt. hilar lymphadenopathy. Rt and left lobe masses.
MRI: no clavicular osteomyelitis
AFB and fungal stains Negative
Bx of lung mass: granulomatous inflammation, possibily vasculitic