Prompt Detail:
Please write a progress note for a 62-year-old man being worked up for a continuous cough and pulmonary opacities. Antineutrophil cytoplasmic antibody and anti–double-stranded DNA antibody tests were negative, normal C3 and C4 levels. Negative urine legionella antigen. A bronchoscopy and transbronchial biopsy were conducted. Right middle lobe bronchoalveolar-lavage fluid was cloudy. Fluid analysis showed 850 nucleated cells per microliter, 48% were neutrophils and 2% were lymphocytes, no eosinophils. Neutrophils and a small amount of gram-positive cocci on Gram's stain. Tests for acid-fast organisms were negative and the culture grew normal respiratory flora and C. albicans.
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