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Pathological Case of the Month
Mary Ann DeLeon, MD;
Alan Johnson, MD
From the Children's Memorial Hospital, Chicago, Ill.
Arch Pediatr Adolesc Med. 2001;155:91-92.
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A 15-YEAR-OLD male had a 4-month history of cough productive of blood-tinged sputum, low-grade fevers, night sweats, progressive left wrist pain, and a 40-lb weight loss. Symptoms and radiographic findings of a right middle lobe pneumonia persisted despite multiple courses of antibiotics, including erythromycin, bactrim, and ciprofloxacin over the next 4 months. He was thought to have an asthmatic component to his respiratory symptoms and was prescribed a course of prednisone and albuterol without improvement. He developed worsening left wrist pain, stiffness, swelling, and dysfunction. Social and travel history was notable only for a brief visit to central Wisconsin 14 months prior to the development of symptoms. Findings from physical examination revealed a cooperative male in no distress. His temperature was 39°C with a respiratory rate of 24, heart rate of 96, and blood pressure of 139/96 mm Hg. He had multiple verrucous . . . [Full Text of this Article]
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