4[degrees]C) and had a nontender left axillary lymphadenopathy; a diffuse maculopapular rash on his chest, abdomen, and back; petechiae on his soft palate and lower extremities; and bibasilar
crackles in the lung fields.
The internist asked my opinion about a 53-year-old lady with a cough and bibasilar
1), (11) Although they are nonspecific, bibasilar
crackles are the cardinal feature on respiratory examination.
He had low blood pressure, and physical examination revealed gynecomastia, bilateral atrophied testis, and bibasilar
In many cases, the diagnosis of idiopathic pulmonary fibrosis is currently made by computerized tomography scan based on the presence of bibasilar
disease with architectural distortion and extensive honeycomb changes.
IPF commonly presents with cough, bibasilar
inspiratory crackles, and finger clubbing.
Auscultation: Decreased aeration throughout with course bibasilar
(Right > Left) crackles on inspiration, but patient effort may have been suboptimal.
Chest radiograph showed moderate bilateral pleural effusions and bibasilar
opacities suggestive of a pneumonic process.
Serial chest imaging showed development of bibasilar
consolidation (Figure 2.
High-resolution CT scans will demonstrate bibasilar
reticular abnormalities with focal honeycomb cystic changes.
A thoracic CT scan showed a good result from the left pleurodesis, but patchy, subpleural, peripheral, bibasilar
and reticular abnormalities with airspace consolidation, rather than ground glass opacification, more accentuated on the right lung (Figure 1B).
Review labs with Bibasilar
crackles, Request lab them and expected positive peripheral results.