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Pulmonary and Critical Care Pearls |

A 74-year-old Man With Chronic Lymphocytic Leukemia, Cough, and a Lung Mass*

Douglas Michaelsen, MD; Marc A. Judson, MD, FCCP
Author and Funding Information

*From the Department of Medicine (Dr. Michaelsen) and the Division of Pulmonary and Critical Care, Allergy and Clinical Immunology (Dr. Judson), Medical University of South Carolina, Charleston, SC.

Correspondence to: Marc A. Judson, MD, FCCP, Division of Pulmonary and Critical Care, Allergy and Clinical Immunology, Medical University of South Carolina, 96 Jonathan Lucas St, 812 CSB, Box 250623, Charleston, SC 29425



Chest. 1999;116(6):1798-1801. doi:10.1378/chest.116.6.1798
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Extract

The patient was a 74-year-old white man with a history of stage IV chronic lymphocytic leukemia (CLL) diagnosed 6 years previously. The last cycle of chemotherapy that he received was fludarabine 14 months prior to admission. Additional history was significant for bouts of recurrent bronchitis over the previous 6 months. One month prior to admission, the patient presented with a persistent cough, and he was noted to have a decreased hematocrit and platelet count. Chest CT done at that time demonstrated increased subcarinal, mediastinal, and hilar adenopathy. Therefore, a decision was made to restart fludarabine treatment. The patient presented to the clinic 1 day after initiation of fludarabine with complaints of severe cough that was productive of greenish-yellow, blood-tinged sputum. He also complained of increased shortness of breath, shaking chills, and fever to 38.8°C.

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