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Autopsy and Medicine
March 9, 1998

Case of the Month

Randy Hanzlick, MD; Larry Nicohols, MD; and the Autopsy Committee of the College of American Pathologists
Arch Intern Med. 1998;158(5):426. doi:10.1001/archinte.158.5.426

A 59-YEAR-OLD woman presented with a 13.5-kg weight loss, malaise, and chronic cough of 2 months' duration. The results of a chest x-ray examination suggested a cavitary lesion of the left upper lobe, and based on empirical evidence, she was given antituberculous medications. Sputum cultures had not yet been obtained when, 2 days after admission, she was found dead on the floor in the bathroom of her hospital room with copious amounts of blood emanating from the nose and mouth. A family member with human immunodeficiency virus infection had been living in her home, but the deceased patient had no serologic or clinical evidence of human immunodeficiency virus infection. Six months earlier, she had been admitted for respiratory symptoms and was diagnosed as having bacterial pneumonia in the left upper lobe, which was treated with antibiotics during a short hospital stay.

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