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January 22, 1968

Unresolving Pneumonia

Author Affiliations

From the weekly X-ray Seminar, Department of Radiology, Massachusetts General Hospital, Boston.

JAMA. 1968;203(4):287-289. doi:10.1001/jama.1968.03140040039010

Dr. Reginald E. Greene: A 56-year-old white man was admitted to this hospital after repeated episodes of hemoptysis over a three-month period. His illness began with fatigue, malaise, hoarseness, and cough. He ran a low-grade fever and was treated with two courses of penicillin for pneumonia. During the second course of antibiotic therapy, he noted a single episode of a dull ache in the right anterior portion of the chest. He had been a heavy smoker for years and was transiently exposed to a brother-in-law who had died of tuberculosis recently. Because of the absence of significant symptomatic improvement, he was referred to this hospital for admission.

Pertinent physical findings included a normal temperature and decreased breath sounds over the right middle lobe area with crepitant rales. The findings of the remainder of the examination were normal. An intermediate strength purified protein derivative (PPD) test was strongly positive. Other laboratory