-year-old white man developed a febrile illness for 2 to 3 weeks that
was associated with retrosternal chest pain radiating to the back in
May 1997. The patient was treated with a course of oral antibiotics
with some improvement. However, several weeks later, he developed
exertional shortness of breath and pedal edema. He denied orthopnea or
paroxysmal nocturnal dyspnea. He had gained 30 lb in weight.
His medical history was significant for type II diabetes, for which he
used glyburide. He had a 10-pack-year history of smoking and had quit
10 years ago. His alcohol intake was modest, and he denied use of
illicit drugs. He worked as a mechanic assembling computers. There was
no history of travel abroad. There was no history of tuberculosis (TB)
or TB contact.