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Case Reports
. 2017 Jun 1;376(22):2183-2188.
doi: 10.1056/NEJMcps1610072.

Spiraling Out of Control

Sara Mixter  1 , Reza Sedighi Manesh  1 , Sara C Keller  1 , Laura Platt  1 , Harry Hollander  1
Affiliations
Case Reports

Spiraling Out of Control

Sara Mixter et al. N Engl J Med. .

Abstract

A 22-year-old man presented to the emergency department on Christmas Day with a 5-day history of myalgias, cough, dyspnea, nonbilious emesis, and nonbloody diarrhea. Although he had been ill for several days, he ultimately sought treatment because of intractable vomiting. He reported feeling feverish, although he had not measured his temperature, and noted one episode of hemoptysis.

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Conflict of interest statement

Dr. Manesh reports receiving honoraria from the Human Diagnosis Project for serving as supervising editor for the Global Morning Report section of the Human Diagnosis Project. No other potential conflict of interest relevant to this article was reported.

Figures

Figure 1.
Figure 1.. Axial CT Scan of the Chest, Showing Tree- in-Bud Nodularity and Centrilobular Nodules.
An axial computed tomographic (CT) scan of the chest shows diffuse, mild tree-in-bud nodularity and centrilobular nodules involving the right and left upper lobes (Panel A) and lower lobes (Panel B).
Figure 2.
Figure 2.. Anteroposterior Radiograph of the Chest, Showing Patchy Infiltrates.
An anteroposterior radiograph of the chest, obtained with portable equipment soon after the patient’s admission to the intensive care unit, shows patchy infiltrates involving both lungs, with the right lung showing greater infiltration than the left.
See this image and copyright information in PMC

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