A 67-year-old man with granulomatous polyangiitis (Wegener granulomatosis) complicated by end-stage renal disease requiring hemodialysis and mild pulmonary fibrosis, was hospitalized with a 2-week history of worsening dyspnea and dry cough. He was taking 20 mg prednisone and 150 mg azathioprine daily.
On examination, he was afebrile and had diffuse rhonchi and expiratory wheezes. A chest computed tomography (CT) scan revealed bilateral nodular infiltrates and a 1.3-cm cavitary nodule in the right upper lobe. Bronchoscopy was performed on day 2. Blood and bronchoalveolar lavage fluid test results are presented in the Table.
Miceli MH, Kauffman CA. Aspergillus Galactomannan for Diagnosing Invasive Aspergillosis. JAMA. 2017;318(12):1175–1176. doi:10.1001/jama.2017.10661
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