Case 32-2001

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Abstract
Presentation of CaseA 77-year-old man was transferred to this hospital because of worsening bilateral air-space disease and acute renal failure.He had stopped smoking 30 years before admission. He had mild chronic obstructive pulmonary disease; hypertension, for which he was taking lisinopril; and rheumatoid arthritis, which had begun one and a half years before admission and was being treated with indomethacin and hydroxychloroquine.Six days before admission, the patient entered another hospital because of an acute onset of dyspnea, without fever. Bilateral rales and rhonchi were audible. A thoracic radiograph showed numerous diffuse pulmonary opacities and a minimal right-sided . . .