Contributed by Kevin D. Horn, MD and William A. Pasculle, ScD
Published on line in November 1997
The patient was a 37 year old white male with a clinical history of recent fever of 3 1/2 weeks duration, with temperatures ranging from 102 to 103 oF. He reported new onset swelling in his legs bilaterally and was admitted to the hospital for further evaluation. His past medical history was significant for a 40-50 pack year tobacco history and exposure in the steel industry to industrial dust and fumes. He reported an allergy to penicillin, to which he develops a rash. A chest x-ray and CT scan obtained at the time of admission revealed a 4 cm right hilar mass and possible enlargement of mediastinal lymph nodes.
On the following day, the patient underwent an uncomplicated flexible bronchoscopy and mediastinoscopy. The mediastinal lymphoid tissue appeared grossly normal, and a specimen was sent for pathologic examination and culture.
On postoperative day #1, the patient was afebrile. His vital signs were stable. Blood pressure was 120/80. He tolerated oral food intake well, and it was felt at this time he was stable for discharge to home.
ANTIBIOTIC SUSCEPTIBILITY TESTING