Correct!
4. A + C
Old x-rays should be compared to the most recent x-ray to determine the age of any lesion(s). This would be a very unusual presentation both clinically and radiographically for a pulmonary embolus. In areas such as Arizona where Valley Fever is endemic a coccidioidomycosis serology is indicated when evaluating most chest processes.
In our patient old chest x-rays did not show the lower lobe lesions and a coccidioidomycosis serology was negative. To better define the lesions a chest CT was done (Figure 2).
Figure 2. Representative images from the thoracic CT scan. Click here for a movie of the CT scan.
What is the next most appropriate step?
