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Pulmonary nodules and splinter haemorrhages
A Schattner, N Kozak, J FriedmanDepartment of
Medicine, Kaplan Medical Centre, Rehovot and the Hebrew
University-Hadassah Medical School, Jerusalem, Israel
Correspondence to: Professor Ami Schattner, Department of Medicine, Kaplan Medical Centre, 76100 Rehovot, Israel amiMD@clalit.org.il
Submitted 12 April
2000;
Accepted 22 June 2000
| The first 150 words of the full text of this article appear below. |
A 42 year old man developed upper
respiratory symptoms that were accompanied by a marked decrease in
appetite, severe fatigue, and the later appearance of arthralgia of the
ankles and of drenching night sweats. He was admitted in January 2000, after he had been ill for one month, showed no response to cefuroxime,
and had a chest x ray which revealed
multiple pulmonary nodules (fig 1). The patient was a gardener who
smoked heavily and had a distant history of drug abuse but was
otherwise healthy. On examination low grade fever (37.7°C), sinus
tachycardia (104 beats/min), enlarged red tonsils, right
conjunctivitis, and tenderness over one knee, were the only notable
findings. The erythrocyte sedimentation rate was 109 mm/hour,
haemoglobin concentration 119 g/l (mean corpuscular volume 90 fl),
leucocytes 12 × 109/l with 75% neutrophils and 6%
eosinophils, and platelets 461 × 109/l. The urinary
sediment, renal function tests, and electrolytes were normal. Serum
albumin was 29 g/l,
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