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Case 4 This 43 year-old man worked at a municipal water treatment plant. He was transferred to UHC after four days of hospitalization at an outside hospital with refractory pneumonia and respiratory failure. He presented initially eleven days before death with cough productive of bloody yellow sputum, fever, and dyspnea. Past medical history was significant for type 2 diabetes, hypertension, and coronary atherosclerosis. Chest X-ray showed bilateral nodular infiltrates which did not respond to broad- spectrum antibiotics or amphotericin B. Blood cultures were persistently negative. His hospital course was significant for progressive respiratory failure requiring intubation, and for hypotensive episodes leading to renal failure. He succumbed to multiple organ failure without significant resolution of his pulmonary infiltrates. Presented by Dr. Robert Hoffman. (Please click on the images below--they will open in a small window).
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