Iagnostic Dilemma: Infectious Disease

RESENTATION negative test result proved misleading in the case of a 1-year-old woman from Chihuahua, Mexico. During one f her frequent visits to a daughter in the United States, the oman presented with a 2-month history of intermittent emoptysis, weight loss, and night sweats. She had no istory of chest pain, dyspnea on exertion, fever, chills, ematemesis, melena, or epistaxis, and she denied use of obacco, alcohol, or injectable drugs. However, she had type diabetes mellitus, hypertension, and 12 years earlier, she nderwent mastectomy, chemotherapy, and radiotherapy for ancer of the right breast. Five years before her current admission, the patient was iagnosed with pulmonary tuberculosis based on a positive 30 mm) tuberculin skin test and a radiographic finding of a eft apical cavitation (Figure 1). At that time, her husband ad confirmed pulmonary tuberculosis, so although her dignosis was never verified with a culture, she received ntitubercular therapy for 4 months.