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- Infection control
- opportunist lung infections
- sarcoidosis
- bronchoscopy
- COPD Pathology
- drug induced lung disease
- histology/cytology
- interstitial fibrosis
- lung cancer
- lung cancer chemotherapy
- pleural disease
- alveolar cell cancer
- anca related vasculitides
- eosinophil biology
- lymphocyte biology
- macrophage biology
- respiratory infection
Clinical presentation
A 42-year-old woman was referred to our department with a 5 months history of intermittent fever and fatigue. Her past medical history included a consolidated diagnosis of sarcoidosis (obtained 7 years before with a sub-carinal lymph node biopsy) and in the previous years she had been treated with steroids, hydroxychloroquine, methotrexate and azathioprine with persistent and progressive enlargement of mediastino-hilar adenopathies and bilateral nodular infiltrates. Her symptoms progressed despite a course of antibiotics prescribed for presumed community-acquired pneumonia and a course of corticosteroids. The patient lived in Italy and there was no history of travels or other additional risk factors for infections.
At the time of admission, the patient had a temperature of 38.5°C and the physical examination was only notable for hepatomegaly and …