In this Discovery Clinical Pathological Conference (CPC), Drs. Alyssa Mohammed and Eva Amenta, Residents, Department of Medicine, discuss the case of a 27-year old male with a recent prolonged hospitalization due to pneumonia who presented with dyspnea and perioral cyanosis. Dr. Uma Ayyala, Assistant Professor, Department of Medicine, Section of Pulmonary, Critical Care, and Sleep Medicine at Baylor College of Medicine, serves as the faculty discussant. Dr. Ayyala reviews the pertinent negatives and positives of the given history and physical exam. She outlines important laboratory and radiological studies that would aid in evaluating the patient’s condition and narrowing down her differential diagnosis.

Dr. Varshana Gurusamy, Resident, Department of Radiology at Baylor College of Medicine, reviews the patient’s chest x-ray and CT scan and highlights the effects these assessments have on the patient’s overall clinical picture. Dr. Stephanie Holdener, Resident, Department of Pathology at Baylor College of Medicine, discusses the pathologic findings of the patient’s bronchoalveolar lavage (BAL) and reviews the process that helped her team arrive at the final diagnosis. Dr. Ayyala returns to the podium to summarize the case and the management of the patient’s condition.