In: Influenza21 Nov 2012
In five patients, chest roentgenograms showed increased interstitial markings bilaterally; however, most were without acute change when compared with prior or later roentgenograms. One patient had a chest roentgenogram abnormality believed to represent an acute viral pneumonia (Fig 2); the course of illness in this patient is summarized as follows: A 42-year-old gay male smoker with a history of mild asthma was admitted to the hospital with complaints of fever, chills, sweats, a cough productive of scant yellow sputum, and increasing shortness of breath of one weeks duration. Oral temperature was 38.7°C, heart rate was 130/min, and respiratory rate was 32/min. Examination revealed mild respiratory distress, oral thrush, and diffuse expiratory wheezing. Room air arterial blood gas showed the following: pH, 7.47; Pco2, 31 mm Hg; and Po2, 56 mm Hg. Chest roentgenogram revealed a difluse alveolar-interstitial infiltrate bilaterally. Diagnostic bronchoscopy with biopsy was performed on the fifth hospital day because of absence of P carinii on an induced sputum specimen and lack of response to empiric high-dose intravenous trimethoprim-sulfamethoxazole therapy.
Figure 2. Diffuse alveolar-interstitial infiltrate in a patient with influenza infection.
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