Case 50

 An eighty two-year-old male called an ambulance for his body temperature rising 40 centigrade. Because his son living together got common cold, he thought he caught a cold from his son. He made an active daily life and usually supplied breakfast for his family members: two sons and one grandchild. An emergent doctor realized his abnormal respiratory sound: ralle and coarse at the left lower chest and then, ordered blood test and chest CT. Laboratory test revealed positive influenza A, elevation of CRP 3.5 mg/dl, procalcitonin 14.0 ng/ml (< 0.5), LDH 322 U/L creatinin 1.62 and neutophils of 92.9 %, monocytes of 3.3% and normal value of white blood cells of 7060 mm³ (4000-8000). Pneumococcus and Legionnaire infections were negative in urine.

In case of influenza pneumonia, which findings are found on chest CT ?

a. Ground glass attenuation

b. Cosolidation

c. Air space nodules (centre-lobular nodules)

d. Bronchial wall thikening

1. a, b, c　　 2. b, c, d 　　 3. a, c, d 　　 4 all

answer

2017.4.12