Morning report 1.29.2020

Today we discussed a middle-aged patient with 15 year history of dyspnea and fatigue. Previous investigations revealed obstructive PFTs, ground-glass opacities on CT imaging and noncaseating granulomas on lung biopsy. We discussed the DDx of granulomatous disease in the lung (not only sarcoidosis / fungal infections!). Further history for exposures revealed daily use of a hot tub (with a malfunctioning filter!). Removal of the hot tub exposure alleviated most of the patient’s symptoms. This is a interesting case from NEJM with similar discussion in a more acute presentation. nejmcpc059003



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