Vikas Agarwal
@vikasagrIMMUNO
ID:780376796931829760
26-09-2016 12:01:41
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#ClinicalPearl What is the most likely diagnosis? Hint MCPs spared, PIPs spared mostly. Pt was gardening on a sunny day.
#idboardreview 20 F cough, F, fatigue not improving on azithro, no travel, +gardening: wbc 17k 90%pmn, CXR patchy nodules: biopsy necrotizing granulomas; stain Aspergillus. Growing up, pt & her brother had several episodes of cervical lymphadenitis. How to make dx? #idtwitter