A 30-year old male presented with fever, dry cough and weight loss of 6 months duration. The chest x ray shows miliary pattern. The differential diagnosis includes all the following except
In Wegener's granulomatosis,lung involvement typically appears as multiple,bilateral,nodular cavitary infiltrates,which on biopsy reveal the typical necrotizing granulomatous vasculitis.The patients present with cough,hemoptysis,dyspnea,and chest discomfo. In military tuberculosis,chest radiography reveals a military reticulonodular pattern.They present with fever,night sweats,anorexia,weakness,weight loss,cough,hemoptysis and other respiratory symptoms.In fungal infections like aspergillosis,there will be focal infiltrates in chest radiograph.Such patients often present with fever,breathlessness,cough productive of bronchial casts and worsening of asthmatic symptoms.In sarcoidosis,chest radiograph shows bilateral hilar lymphadenopathy and infiltrates.The patients often present with cough,dyspnea,fever,fatigue,night sweats and weight loss. Ref:Harrison's medicine-18th edition,page no:2789,1349,2807;Davidson's medicine-22nd edition,page no:697.
Tuberculosis
Wegener's granulomatosis
Fungal infection
Sarcoidosis
Respiratory system