March 2022 Pulmonary Case of the Month: A Sore Back Leading to Sore Lungs

L. Wesselius, Brandon Larsen
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Abstract

No abstract available. Article truncated after 150 words. History of Present Illness An 82-year-old woman from Colorado was referred because of progressive shortness of breath over the past year. Her primary care physician had prescribed Trelegy® which did not improve her dyspnea. An outside pulmonologist noted abnormal findings on her thoracic CT scan and a bronchoscopy with bronchoalveolar lavage (BAL) was preformed which was positive for Mycobacterium Avium Complex (MAC). She was treated with a 3-drug regimen (azithromycin, rifampin, ethambutol) for 6 months with mild improvement. After the treatment was stopped, she noted more dyspnea and required supplemental oxygen. She underwent a fundoplication and initially improved but a month later her shortness of breath seemed to worsen. She was started on prednisone which was tapered to 10 mg/day. She was referred to the Mayo Clinic for possible VATS lung biopsy. Past Medical History (PMH), Social History (SH), Family History (FH) PMH • Hiatal Hernia/GERD • Ulcerative Colitis • Hypertension • Chronic back …
本月肺部病例:背部疼痛导致肺部疼痛
没有摘要。文章在150字后被删节。现病史一名82岁科罗拉多州妇女因过去一年进行性呼吸短促被转诊。她的初级保健医生给她开了Trelegy®,但没有改善她的呼吸困难。一位外部肺科医生在她的胸部CT扫描和支气管镜检查中发现异常,支气管肺泡灌洗(BAL)对鸟分枝杆菌复合体(MAC)呈阳性。患者接受3药联合治疗(阿奇霉素、利福平、乙胺丁醇)6个月,病情轻度好转。停止治疗后,她发现呼吸困难加重,需要补充氧气。她接受了手术,最初有所好转,但一个月后,她的呼吸短促似乎恶化了。她开始使用强的松,逐渐减少到每天10毫克。她被转到梅奥诊所进行可能的VATS肺活检。既往病史(PMH),社会史(SH),家族史(FH) PMH•裂孔疝/胃食管反流•溃疡性结肠炎•高血压•慢性背部…
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