Case 23-1995

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Abstract
Presentation of CaseA 44-year-old woman was transferred to this hospital because of severe respiratory distress, bilateral pulmonary infiltrates, and increasing pancytopenia.The patient had been well until 34 days earlier, when a cough productive of scanty whitish sputum developed. Treatment with erythromycin was unsuccessful. Progressive exertional dyspnea developed, and two weeks before entry she was admitted to another hospital. Examination showed that the temperature was 39.4°C; bilateral basal crackles were present. Radiographs of the chest revealed bilateral dense pulmonary infiltrates. Trimethoprim–sulfamethoxazole, doxycycline, and prednisone (40 mg twice daily) were administered.On the fourth hospital day a bronchoscopic examination was . . .