A 48-year-old man presents with 3 weeks of fever, fatigue, and shortness of breath. He has a history of "nasal allergies" and asthma, which have been poorly controlled in the past month. Two days prior to presentation, he developed weakness in his left foot and it now "drags" when he walks. On examination, his blood pressure is 165/90 mm Hg, pulse 100/min, respirations 20/min, and lungs have bilateral expiratory wheezes. There is left foot drop, and the rest of the neurologic examination is normal. Laboratory evaluation reveals ESR of 90 mm/h, WBC of 14,000/mL with 10% eosinophils, and 1+ proteinuria. A CXR shows bilateral pulmonary infiltrates.For the above patient with vasculitis syndrome, select the most likely diagnosis.
Churg-Strauss is a granulomatous vasculitis. Pulmonary involvement often dominates the clinical presentation with severe asthma attacks and pulmonary infiltrates. Peripheral eosinophilia is present in virtually all cases.
polyarteritis nodosa (PAN)
Churg-Strauss disease
Henoch-Schonlein purpura
vasculitis associated with infectious diseases
Miscellaneous