Mystery Quiz

July 23, 2008

Posted by Nishay Chitkara MD, Instructor of Clinical Medicine, Division of Pulmonary and Critical Care Medicine, Vivian Hayashi MD, Instructor of Clinical Medicine, Division of General Internal Medicine and Robert Smith MD, Associate Professor of Medicine, Division Pulmonary and Critical Care Medicine 

A 49 year old undomiciled male with a history of hepatitis C, mycobacterium avium complex colonization of the lungs, and active alcohol abuse presented with fevers, cough productive of green sputum, and an elevated white blood cell count. His symptoms were persistent despite broad spectrum antibiotics, including vancomycin and piperacillin/tazobactam. He had the following radiographic findings:

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