80-year-old man with intermittent cough and blood-tinged sputum for 3 months - USMLE Forums
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  #1  
Old 10-17-2011
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Lungs 80-year-old man with intermittent cough and blood-tinged sputum for 3 months

An 80-year-old man was admitted with the complaints of intermittent cough with blood-tinged sputum for 3 months. His cough usually aggravated at night, and no prominent chest pain, anorexia or body weight loss was noted. He smoked cigarettes 1 pack a day for over 50 years and quitted 3 years ago. He had a gingival inflammation several months ago and underwent local treatment irregularly. Respiratory examinations found no cervical lymphadenopathy, musculoskeletal disorder or other abnormalities. His blood pressure was 150/80 mmHg. Chest X-ray revealed a solitary nodular shadow over the left upper lung field.
The positron emitted tomogram (PET) revealed a hypermetabolic lesion over the left upper lobe of the lung of the patient, which favors a malignancy. The patient underwent a surgical resection. The B1 segmentectomy was performed smoothly through a 4 cm utility incision and a 1 cm port for scope. The gross picture of the mass was yellowish, elastic on palpation, and without prominent pleural retraction.
The frozen section did not show malignant cells and the subsequent pathological examination demonstrated the aggregates of filamentous Gram-positive microorganism in the characteristic of sulfur granules. What is the most likely diagnosis?

A) Nocardiosis
B) Candidiasis
C) Cryptococcosis
D) Actinomycosis
E) Aspergillosis
F) Histoplasmosis
G) Coccidiomycosis
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  #2  
Old 10-18-2011
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i`l go with D = Actinomycetes
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  #3  
Old 10-18-2011
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Its Actinomycetes
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Old 10-18-2011
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Originally Posted by m82_ghasemi View Post
An 80-year-old man was admitted with the complaints of intermittent cough with blood-tinged sputum for 3 months. His cough usually aggravated at night, and no prominent chest pain, anorexia or body weight loss was noted. He smoked cigarettes 1 pack a day for over 50 years and quitted 3 years ago. He had a gingival inflammation several months ago and underwent local treatment irregularly. Respiratory examinations found no cervical lymphadenopathy, musculoskeletal disorder or other abnormalities. His blood pressure was 150/80 mmHg. Chest X-ray revealed a solitary nodular shadow over the left upper lung field.
The positron emitted tomogram (PET) revealed a hypermetabolic lesion over the left upper lobe of the lung of the patient, which favors a malignancy. The patient underwent a surgical resection. The B1 segmentectomy was performed smoothly through a 4 cm utility incision and a 1 cm port for scope. The gross picture of the mass was yellowish, elastic on palpation, and without prominent pleural retraction.
The frozen section did not show malignant cells and the subsequent pathological examination demonstrated the aggregates of filamentous Gram-positive microorganism in the characteristic of sulfur granules. What is the most likely diagnosis?

A) Nocardiosis
B) Candidiasis
C) Cryptococcosis
D) Actinomycosis
E) Aspergillosis
F) Histoplasmosis
G) Coccidiomycosis

D.Actinomycosis....Someone wrote that big a question, just for this answer...aghhh....
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Evergreen (10-22-2011), m82_ghasemi (10-18-2011)
  #5  
Old 10-21-2011
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D) Actinomycosis
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Evergreen (10-22-2011)



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