TEST - Book of PDFs-01_Johnson_Johnson-CHEST 2016_CMS PC.pptx

01_Johnson_Johnson-CHEST 2016_CMS PC.pptx - 1

Pdf Summary

A 65-year-old female presented to her primary care physician with new swelling over the left side of her chest. The physical exam revealed a 7x7 cm soft tissue mass in the left breast. No lymph nodes were palpable, and lung examination was normal. The patient had a history of hypertension, tobacco use, and uterine fibroids. Her last mammogram was negative 5 months prior. A chest ultrasound showed an indeterminate mass with internal echoes and flow signal present. CT chest was recommended for further evaluation. The CT scan revealed a diagnosis of blastomycosis, a fungal infection caused by Blastomyces dermatitidis. Blastomycosis most commonly affects the lungs but can also spread to other organs, including the skin. Symptoms include fever, cough, shortness of breath, muscle aches, and weight loss. Skin manifestations of blastomycosis often present as verrucous gray lesions with irregular borders. Treatment for pulmonary blastomycosis typically involves a course of amphotericin B followed by itraconazole for 6-12 months. In another case, a 52-year-old female presented with new onset dyspnea on exertion. The patient had a history of juvenile arthritis and supraventricular tachycardia. Physical examination revealed crackles in the lungs and normal cardiovascular findings. Pulmonary function tests showed normal spirometry and lung volumes. The patient underwent bronchoscopy and biopsy, which confirmed a diagnosis of hypersensitivity pneumonitis (HP), an immune-mediated lung disease caused by exposure to various antigens. HP can present as acute, sub-acute, or chronic forms, each with distinctive clinical and imaging features. Treatment for HP involves avoidance of the offending antigen and, in some cases, glucocorticoid therapy.

Keywords

swelling

soft tissue mass

left breast

blastomycosis

fungal infection

lungs

fever

cough

hypersensitivity pneumonitis

lung disease