Thanks to Lilac Master @hyy838 for providing high-quality cases~
Patient Gender:Female, 46 years old
Brief medical history: Intermittent fever with joint pain for more than 1 month, worsening for 1 day.
History of present illness: The patient has intermittent low-grade fever without obvious incentives for one month, mostly at night, with body temperature fluctuation around 37.5 ℃, occasional dry cough, no obvious cough Sputum, accompanied by pain in bilateral shoulders, palm and finger joints, and dry mouth. During this period, he received anti-infective treatment (clindamycin) in the local hospital for 5 days, and the symptoms were not significantly relieved.
Fever reappeared 1 day ago, with a maximum body temperature of 39.4°C, with chills, still joint pain, dry cough and other symptoms, no sputum, night sweats, hemoptysis, Chest pain, palpitations, dyspnea, dry eyes, Raynaud’s phenomenon, nausea and vomiting, abdominal pain, and diarrhea came to our hospital for further diagnosis and treatment. The patient’s spirit, appetite, and sleep were okay, his physical strength decreased, and his body weight did not change significantly.
Auxiliary test: CT-guided biopsy
Clinical Diagnosis: Infection?
First chest CT at our hospital:
Enhanced chest CT
Review 5 days after second CT treatment (patient’s symptoms improved)
Third chest CT (3 months after discharge)
The patient’s condition changed continuously, three CT scans,
Can you tell what disease it is? How to analyze and diagnose?