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Computerized tomography showed right middle lobe hypoplasia with36 ml of right middle and lower lobar pulmonary fluid, ipsilateral BDR,and left midexpiratory flow delay. No other abnormal pulmonary findingswere seen. The patient was hospitalized and treated in the interstitialdisease clinic. The patient’s pulmonary function tests were indicative ofABDR and PAD. The patient received standard ipratropium bromide andmembrane receptor bronchodilator therapy. The doses of ipratropium andalbuterol were increased as needed. Anticholinergic and bronchodilator therapywere effective in decreasing BDR severity and in improving lung function.The patient’s lung function tests were repeated at this time, and a decreasein BDR severity and improvement in lung function were observed. The patientwas monitored in an outpatient clinic, and he received no further treatment. Twelvemonths after starting treatment, the patient’s lung function tests were repeatedand showed significant improvement in BDR severity as well as MMEF(Fig. 3).
An 18-year-old Asian male patient presented with 5 days offever and productive cough with purulent sputum. He had not trippedfalling off a roof, nor had he been in the environment of otherwiseknown exposure to influenza, or tuberculosis. He lived with his parents,worked as a cleaner in a factory, and did not smoke, drink alcohol, oruse drugs. He was a local high school student and was generally in goodhealth. He seemed shy, however, and had a low body mass index. He didhowever say that he had been a frequent inattentive driver in the past. Hewas currently working on a motorcycle that he had been fixing up in hishouse, and he had recently helped his father unload a car, which was parkedoutside. Shortly after this activity, however, he became feverish,urged to vomit, and had moderate chills. His parents initially tookhim to a local hospital, where he was treated for oral thrush andgonococcal pharyngitis. He recovered and exhibited no symptomsother than fever and nonproductive cough with purulent sputum after theend of a 10-day course of cefuroxime and doxycycline. d2c66b5586