Pulmonary examination revealed scattered wheezes with fine bibasilar
New chest imaging done within 24 hours of arrival (Figure 1) showed worsening bibasilar
During the first office visit, Mary was noted to be in a wheel chair, on chronic oxygen therapy (2 L to 3 L via nasal cannula), and severely fluid overloaded with bibasilar
crackles and bilateral lower extremities edema up to the thighs.
In addition, diagnosis of pulmonary fibrosis was established with decreased diffusing capacity of carbon monoxide and diffuse bibasilar
lung fibrosis on computed tomography.
crepitation was the most consistent sign (95.
A computed tomogram (CT) scan of the chest (Figure 2) showed bibasilar
Physical examination was significant for hypoxia, bibasilar
crackles, S3 gallop, and 2+ pitting edema.
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.
On physical examination, he had diminished bibasilar
breath sounds and a right-sided inspiratory wheeze.
On the fourth day in the hospital, he had a fever of 104[degrees] F, "massive" facial swelling, bibasilar
crackles, a systolic murmur, left lower quadrant pain, and a large parietal abscess seen on MRI.
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