Case Presentation

A 71-year-old man with history of gastroesophageal reflux disease, chronic sinusitis, arthritis, hypothyroidism, and anemia of chronic disease initially sought treatment with a recurrent left pleural effusion along with other abnormal lung findings on chest CT scan. Before his referral, he was being managed for 3 years at his local hospital for waxing and waning fevers, fatigue, productive cough, chills, and night sweats. He did not report any hemoptysis or chest pain, but reported weight loss of 13 kgs in 15 months. During those 3 years, he was treated with multiple courses of antibiotics and steroids with temporary relief of symptoms. At that time, his chronic sinusitis was suspected to be the cause of his symptoms and he underwent balloon sinuplasty. He was receiving daily sublingual immunotherapy for inhaled respiratory allergens for the previous year after showing positive test results for 17 inhaled allergens. The patient had no other known immunologic workup before our evaluation.

中文翻译：

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一名 71 岁男性，患有弥漫性上蜡和消退的多灶性肺部病变、脓胸和发作性发热，诊断为罕见

案例展示

一名 71 岁男性，有胃食管反流病、慢性鼻窦炎、关节炎、甲状腺功能减退症和慢性病性贫血病史，最初因左侧胸腔积液复发以及胸部 CT 扫描发现其他肺部异常而寻求治疗。在转诊之前，他在当地医院接受了 3 年的治疗，原因是发烧、疲劳、咳嗽、寒战和盗汗。他没有报告任何咯血或胸痛，但报告称在 15 个月内体重减轻了 13 公斤。在这 3 年中，他接受了多个疗程的抗生素和类固醇治疗，症状暂时缓解。当时，怀疑他的慢性鼻窦炎是他的症状的原因，他接受了球囊鼻窦成形术。在显示 17 种吸入性过敏原检测结果呈阳性后，他在前一年每天接受吸入性呼吸道过敏原的舌下免疫治疗。在我们进行评估之前，该患者没有其他已知的免疫检查。