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Clinical Information
Case Study: 57-year-old Caucasian female in good
functional status with 2 to 4 week history of dyspnea on exertion,
dry cough, desaturation, and low grade fever
History
- 57-year-old Caucasian female in good functional status presented
in September 2001 with 2 to 4 week history of dyspnea on exertion,
dry cough, desaturation, and low grade fever
- Past medical history: hyperlipidemia, arthritis of hip and knee,
GERD
- Hysterectomy 1994, knee replacement 1996, hip replacement 1999,
benign breast biopsy 2001
- Habits: Non-smoker, non-drinker
- Allergies: atorvastatin–LFT abnormalities
- Hobbies: golf
- Occupation: School physical education teacher
- Current medications: glucosamine, esomeprazole, & magnesium
- No exposure to pulmonary toxins
Physical Exam and Work-up
- PE: BP 130/80, P 88, RR of 22/min. SpO2 93% (86% on effort)
on room air. No clubbing noted
- Chest exam with bibasilar rales
- Chest radiograph: “double pneumonia,” unresponsive
to conventional antibiotic therapy
- Referred to pulmonologist
Tests
- CT scan/PFTs obtained
- Serologic tests negative
- Fiberoptic bronchoscopy is performed
- TBBx: Bronchiolitis Obliterans Organizing Pneumonia (BOOP)/Inflammation
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