Case 24--Asymptomatic, Bilateral Opacities in an Older Man

Clinical summary: This 75-year-old man was admitted 8/27/98 for pain in the left leg at rest for two weeks. He had a past history of hemicolectomy for colon cancer in 1988, myocardial infarction in 1990, and endovascular repair of an abdominal aortic aneurysm in 1997. He was alert and oriented. There were no respiratory complaints. Physical examination: HR 90/min, RR 20/min, BP 166/65. Coarse crackles were heard throughout the lungs. He had an ischemic left foot with no tibial pulse. A chest radiograph was abnormal. A bronchoscopy on 9/4 showed no endobronchial lesions, but clear mucinous secretions were noted throughout the airways. Cultures were negative. He underwent right femoral-left femoral bypass surgery on 9/10 for left iliac artery obstruction. Postoperatively, he was hypoxic with an oxygen saturation of 90% on 100% oxygen. Watery diarrhea developed on antibiotic coverage for presumed infection. He died of respiratory failure on 10/6. An autopsy was performed.

Radiology | Image 1 | Image 2 | Image 3 | Discussion

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