Published in:
01-02-2018 | Images in nephrology
Pulmonary nonsegmental micronodules in a patient undergoing hemodialysis
Published in: Clinical and Experimental Nephrology | Issue 1/2018
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A 59-year-old man was hospitalized for fever and dyspnea. The patient was undergoing hemodialysis for diabetic nephropathy. A chest radiograph revealed small nodules distributed throughout the lung parenchyma (Fig. 1). Diffuse nonsegmental micronodules were identified by computed tomography (Fig. 2). There was no excess fluid in the patient. Although miliary tuberculosis was suspected, T-SPOT.TB and polymerase chain reaction were negative. The patient was considered to have atypical pneumonia and was treated with ceftriaxone and azithromycin. Fever and dyspnea gradually improved, and the micronodules were not evident 1 month later. Cultures of sputum and bronchoalveolar lavage fluid were negative for Mycobacteria.
Fig. 1
Chest radiograph showing wide spread small (2–4 mm) nodular opacities distributed throughout both lungs
Fig. 2
Thoracic computed tomography, showing diffuse nonsegmental centrilobular micronodules in both lungs, accompanied with bilateral bronchodilation. There is air space consolidation in the right upper and middle lobes
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