01 Nov Greasy lung By wasif dev0 Comments A 62-year-old retired fire performer came to the emergency department complaining of persistent cough, difficulty breathing, and unintentional weight loss over the last two months. He also mentioned a history of occasional fever but denies night sweats and has not travelled outside of Canada. He shared his past as a fire performer, often swallowing and blowing fire using petroleum-based fuels. He has a 20-pack-year history of smoking and was diagnosed with COPD 5 years ago. On examination, the patient was observed to be in mild respiratory distress with an oxygen saturation of 92% on room air, and auscultation revealed decreased breath sounds in the right lower lung field. Chest radiograph showed a right lower lobe consolidation, as shown in the image, and a high-resolution CT scan revealed diffuse ground-glass opacities in both lungs with areas of consolidation in the right lower lobe. Lab results revealed an elevated white blood cell count and C-reactive protein level. The bronchoscopy showed nothing unusual; culture for acid-fast bacilli and fungi came back negative, with the cytology only highlighting the presence of foamy macrophages. Which of the following is the most likely diagnosis Based on the patient's history and physical examination findings? Tuberculosis Lipoid pneumonia Primary lung tumour Metastatic carcinoma Lung abscess None Time's up Share article:TwitterFacebookLinkedin